The aim of this study is to evaluate the combined utility of the left atrial coupling index (LACI) and left ventricular speckle tracking echocardiography (LVSTE) in improving risk stratification and outcome prediction for patients undergoing Transcatheter Aortic Valve Implantation (TAVI). This study seeks to identify novel prognostic markers that enhance the prediction of mortality, heart failure, and functional recovery, ultimately enabling more personalized clinical decision-making and optimized patient outcomes by integrating the advanced echocardiographic parameters into pre-procedural assessments,.

Transcatheter Aortic Valve Implantation (TAVI) has emerged as a transformative procedure for patients with severe aortic stenosis, particularly those at high surgical risk. However, accurately predicting patient outcomes remains a significant challenge, necessitating improved risk stratification tools. This study aims to evaluate the role of the left atrial coupling index (LACI) and left ventricular speckle tracking echocardiography (LVSTE) in enhancing outcome prediction in patients undergoing TAVI.

By integrating advanced echocardiographic parameters, such as LACI, which reflects left atrial function and ventricular-atrial interaction, and LVSTE, a sensitive measure of myocardial deformation, this research seeks to uncover novel prognostic markers. A prospective cohort of TAVI patients will be studied to assess the association between these indices and post-procedural outcomes, including Repeated hospitalization, heart failure, stroke and myocardial infarction.

Inclusion Criteria:

• Patients diagnosed with severe aortic stenosis and scheduled for TAVI.

Exclusion Criteria:

• Patients with significant mitral or tricuspid valve disease requiring intervention.
• History of atrial fibrillation or other arrhythmias that preclude accurate LACI measurement.
• Poor echocardiographic window preventing reliable imaging.

Patients with severe aortic stenosis and scheduled for TAVI will be recruited from Madina Cardiac Center over a period of 12 months Data Collection

• Baseline Clinical Data: Demographic information, comorbidities, and clinical risk scores
• Echocardiographic Assessment:

Pre procedural transthoracic echocardiography (TTE) will be performed to measure: Left Atrial Coupling Index (LACI):

Left Ventricular Speckle Tracking Echocardiography (LVSTE): Global longitudinal strain (GLS) will be measured to quantify myocardial deformation.

All echocardiographic measurements will be performed by experienced operators blinded to clinical outcomes.