biostudies-literatureButcher SCEuropean Society of Cardiology1638-1648https://www.ebi.ac.uk/biostudies/studies/S-EPMC11601807biostudies-literatureUnknown25(12)<h4>Aims</h4>To evaluate the prognostic implications of the left atrial reservoir strain-defined diastolic dysfunction (LARS-DD) grade in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) and to determine whether post-TAVI LARS was more closely associated with new-onset atrial fibrillation than pre-TAVI LARS.<h4>Methods and results</h4>Pre-TAVI LARS-DD was evaluated by speckle-tracking echocardiography and was assigned as Grade 0 to 1 (LARS ≥24%), Grade 2 (LARS 19-24%), and Grade 3 (LARS <19%). Patients were followed up for the primary endpoint of all-cause mortality from the date of TAVI. For the secondary endpoint, patients with pre- and post-TAVI LARS measurements and no history of atrial fibrillation were evaluated for the occurrence of new-onset atrial fibrillation. A total of 601 patients [median age 81 (76-85) years, 53% males] were included. Overall, 169 patients (28%) were LARS-DD Grade 0/1, 96 patients (16%) were LARS-DD Grade 2, and 336 (56%) were LARS-DD Grade 3. Over a median follow-up of 40 (interquartile range 26-58) months, a total of 258 (43%) patients died. In a comprehensive multivariable Cox regression model, the LARS-DD grade was independently associated with all-cause mortality [adjusted hazard ratio (HR) 1.28 per one-grade increase, 95% confidence interval (CI) 1.07-1.53, P = 0.007]. For the secondary endpoint of new-onset atrial fibrillation, a total of 285 patients were evaluated. Post-TAVI LARS (subdistributional HR 1.14 per 1% <20%, 95% CI 1.05-1.23, P = 0.0009), but not pre-TAVI LARS (P = 0.93), was independently associated with new-onset atrial fibrillation.<h4>Conclusion</h4>An increased LARS-DD grade was independently associated with long-term post-TAVI survival in patients with severe AS. Post-TAVI LARS was closely related to the occurrence of new-onset atrial fibrillation.European heart journal. Cardiovascular ImagingPrognostic implications and alterations in left atrial deformation following transcatheter aortic valve implantation.PMC11601807App000080404de Weger Avan der Kley FStassen JMarsan NAvan Rosendael PJPlayford DDelgado VBax JJKuneman JHPereira ARMeucci MCHirasawa KButcher SCfalsePrognostic implications and alterations in left atrial deformation following transcatheter aortic valve implantation.<h4>Aims</h4>To evaluate the prognostic implications of the left atrial reservoir strain-defined diastolic dysfunction (LARS-DD) grade in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) and to determine whether post-TAVI LARS was more closely associated with new-onset atrial fibrillation than pre-TAVI LARS.<h4>Methods and results</h4>Pre-TAVI LARS-DD was evaluated by speckle-tracking echocardiography and was assigned as Grade 0 to 1 (LARS ≥24%), Grade 2 (LARS 19-24%), and Grade 3 (LARS <19%). Patients were followed up for the primary endpoint of all-cause mortality from the date of TAVI. For the secondary endpoint, patients with pre- and post-TAVI LARS measurements and no history of atrial fibrillation were evaluated for the occurrence of new-onset atrial fibrillation. A total of 601 patients [median age 81 (76-85) years, 53% males] were included. Overall, 169 patients (28%) were LARS-DD Grade 0/1, 96 patients (16%) were LARS-DD Grade 2, and 336 (56%) were LARS-DD Grade 3. Over a median follow-up of 40 (interquartile range 26-58) months, a total of 258 (43%) patients died. In a comprehensive multivariable Cox regression model, the LARS-DD grade was independently associated with all-cause mortality [adjusted hazard ratio (HR) 1.28 per one-grade increase, 95% confidence interval (CI) 1.07-1.53, P = 0.007]. For the secondary endpoint of new-onset atrial fibrillation, a total of 285 patients were evaluated. Post-TAVI LARS (subdistributional HR 1.14 per 1% <20%, 95% CI 1.05-1.23, P = 0.0009), but not pre-TAVI LARS (P = 0.93), was independently associated with new-onset atrial fibrillation.<h4>Conclusion</h4>An increased LARS-DD grade was independently associated with long-term post-TAVI survival in patients with severe AS. Post-TAVI LARS was closely related to the occurrence of new-onset atrial fibrillation.2024-01-01T00:00:00Z2024 Nov2025-04-19T17:37:03.074Z2025-04-19T17:37:03.074ZS-EPMC116018073898469310.1093/ehjci/jeae170