Aortic valve stenosis
Initially, partly fibrotic changes (GLS -21 to -15%) in a compensated state, in the long run diffuse „replacement“ fibrosis (cut-off -16,2%) — LV & LA stiffness & diastolic dysfunction increase
EF is not a primary benchmark for outcome
EF (acute) & GLS (acute and gradually) improve — GLS as a good follow-up parameter (reverse remodeling) post-operatively
TAVR
Strain as a marker for PM-dependency
Apical to basal Strain ratio >1,9 as a marker for PM dependency
Calculation in the 17-segment model: GLS Apex (5 segments) / GLS basis (6 segments)
Examples: pre-TAVR: 73/63=1,159
Post TAVR without PM dependency likely: 81/89 =0,91
Significant improvement of the GLS in critical AS post TAVR
