Right Ventricular Function Assessment Following Transcatheter Aortic Valve Implantation/Replacement (Tavi/Tavr): A Systematic Review and Meta-Analysis Comparing Speckle Tracking and Conventional Echocardiographic Approaches Publisher Pubmed



Goudarzi E ; Aghajani S ; Ebrahimi N ; Akarzadeh D ; Javadi M ; Layegh Mirhosseyni SS ; Zarinfar Y ; Khaheshi I
Source: Journal of Echocardiography Published:2026

Abstract

This study evaluates alterations in right ventricular strains using speckle-tracking echocardiography (STE) following transcatheter aortic valve implantation/replacement (TAVI/TAVR) and compares these alterations with conventional echocardiographic measurements. A systematic search identified studies assessing RVFWLS and RVGLS via STE pre- and post-TAVI/TAVR. Secondary outcomes included LVEF, TAPSE, FAC, and LVGLS changes. Echocardiographic parameters of TAVI/TAVR patients were compared to those of SAVR patients. Subgroup analyses were based on follow-up duration (≤ 1 month vs. >1 month). Meta-regression examined associations between baseline LVEF, RV strain parameters, and AVA with RV strain changes. Risk of bias assessments, sensitivity analyses, and publication bias evaluations ensured result robustness. Thirteen studies comprising 1,399 patients were analyzed. RVFWLS significantly improved post-TAVI/TAVR (MD = 1.57, SMD = 0.23, p < 0.001). RVGLS showed minor improvement (SMD = 0.09, p = 0.028). LVGLS exhibited considerable improvement (MD = 1.14, SMD = 0.27, p < 0.001). RVFWLS demonstrated the most improvement among all parameters at follow-up > 1 month, whereas within the first month, LVGLS showed greater improvement than RVFWLS. (SMD = 0.30, MD = 1.98, p < 0.001). Lower AVA was associated with greater RVFWLS improvement (coefficient= -0.11, p = 0.08). Among the echocardiographic parameters, only RVFWLS and LVGLS showed consistent improvement after TAVI/TAVR. RVFWLS demonstrated the greatest improvement beyond 1 month of follow-up, whereas LVGLS showed the largest early improvement within the first month. In contrast, changes in RVGLS, LVEF, TAPSE, and FAC were generally small.Keywords: speckle-tracking echocardiography, echocardiography, transcatheter aortic valve implantation, transcatheter aortic valve replacement, right ventricle. © Japanese Society of Echocardiography 2025.