Does myocardial external efficiency differ in aortic stenosis patients with reduced contractile function or paradoxical low-flow, low-gradient AS compared to those with preserved function?
Reduced myocardial external efficiency in AS patients with reduced contractile function or paradoxical low-flow, low-gradient AS suggests mitochondrial uncoupling may contribute to their poor prognosis.
AS patients display a persistent ability to maintain normal MVO2 and MEE (ie, the ability to convert energy into stroke work); however, patients with left ventricular ejection fraction <50%; global longitudinal strain greater than -12%; or paradoxical low-flow, low-gradient AS demonstrate reduced MEE. These findings suggest that mitochondrial uncoupling contributes to the dismal prognosis in patients with reduced contractile function or paradoxical low-flow, low-gradient AS.
Hansson et al. (Thu,) studied this question.