Key result
Hypereosinophilic syndrome linked to altered AVA proportions, reduced AAPSE, and impaired LV longitudinal strain.
Why the study?
Aortic valve annular involvement in hypereosinophilic syndrome had not been investigated, despite the aortic valve's role as a pivotal determinant of central hemodynamics.
Does idiopathic hypereosinophilic syndrome alter aortic valve annular dimensions and dynamics compared to healthy controls?
Does idiopathic hypereosinophilic syndrome alter aortic valve annular dimensions and dynamics compared to healthy controls?
Patients with hypereosinophilic syndrome exhibit reduced aortic valve annular plane systolic excursion and impaired basal left ventricular longitudinal strain without significant absolute aortic valve annular dilation.
Answers are grounded in this paper and cite their sources.
Supports screening for subclinical LV dysfunction in idiopathic HES; hypothesis-generating and leaves open long-term prognostic implications.
Introduction: Hypereosinophilic syndrome (HES) is characterized by a sustained elevation in eosinophil counts in the blood and subsequent eosinophil-mediated tissue or organ damage. While the aortic valve is recognized as a pivotal determinant of central hemodynamics, aortic valve annular (AVA) involvement in a series of HES patients has not yet been investigated. Therefore, this investigation aimed to determine potential abnormalities in the AVA dimensions and dynamics in patients with HES and to assess their associations with function of the left ventricle (LV). Methods: The present retrospective study initially consisted of 17 HES patients; however, one subject was excluded because of the suboptimal image quality. The final group of HES patients comprised 16 cases (mean age: 59.7 ± 12.6 years; 11 males). A group of 21 gender- and age-matched healthy subjects served as the controls (mean age: 54.0 ± 4.9 years; 12 males). Results: Among the 16 HES patients, the end-systolic AVA area was greater than, equal to, or smaller than the end-diastolic AVA area in four (25%), three (19%) and nine (56%) cases, respectively. In the matched control group, these proportions proved to be 12 (57%), one (5%) and eight (38%), respectively. No significant differences were found in the end-systolic and end-diastolic AVA minimum and maximum perimeters, areas or diameters between the HES patients and the matched controls, suggesting that no absolute AVA dilation was observed, despite an altered end-diastolic—end-systolic AVA area distribution. The AVA plane systolic excursion (AAPSE) was significantly decreased in the HES patients (0.91 ± 0.29 cm vs. 1.12 ± 0.24 cm, p = 0.05). Among the basal LV strain parameters, only the LV longitudinal strain (LS) was significantly impaired in the HES patients (−16.63 ± 4.99% vs. −21.62 ± 4.76%, p < 0.05). Conclusions: In HES patients, the AVA is not significantly dilated. However, a greater end-diastolic AVA area is found to be more frequently present compared with age- and gender-matched healthy controls. In addition, AAPSE and basal LV-LS are significantly reduced in HES patients.
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Nemes et al. (2026) studied this question. In patients with hypereosinophilic syndrome, AVA showed altered proportions with reduced AAPSE and impaired LV longitudinal strain.
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