In this study the investigators will assess a variety of novel markers of heart strength (contractility) and assess whether they can give a clearer indication of how well patients with weak hearts respond to the TAVI procedure. The investigators will perform a stress echocardiogram prior to each TAVI procedure and measure the global longitudinal strain (GLS) in the left ventricle (LV) heart muscle, a detailed marker of muscle strength. The investigators will then proceed to the TAVI procedure and measure the contractility of the main pumping chamber in the heart before and after giving a very low dose of an adrenaline -like drug (dobutamine). The patient will already have received this short acting drug (at the same and higher doses) during their routine care planning stress echocardiogram.
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Change in LV ejection fraction at 3 months compared to pre procedural readings.
Timeframe: 3 months
Change in LV Volume at 3 months compared to pre procedural readings.
Timeframe: 3 months
Change in global longitudinal strain at 3 months compared to pre procedural readings.
Timeframe: 3 months
Change in fractional shortening by echocardiography at 3 months compared to pre procedural readings.
Timeframe: 3 months
The change in contractility (dP/dT) with low dose dobutamine stress prior to TAVI, measured by invasive Pressure Wire
Timeframe: 3 months
The change in aortic trans-valvular gradient with low dose dobutamine stress during TAVI prior to AV treatment.
Timeframe: 3 months
The change in contractility (dP/dT) from pre to post procedure at 3 months.
Timeframe: 3 months