Myocardial Oxygen Consumption and Efficiency in Aortic Valve Stenosis Patients With and Without Heart Failure

Figures

• 

  Figure 1. MEE and oxygen consumption. MEE declined late, and MVO2 was constant regardless of study group (A), despite deteriorating GLS (B), LVEF (C), or increasing NT‐proBNP (D). Values are mean±SD. *P<0.05 vs other groups (except for LVEF <50 vs 50–59 [P=0.20]). AsympEF ≥50 indicates asymptomatic aortic valve stenosis patients with left ventricular ejection fraction ≥50%; GLS, global longitudinal strain; LVEF, left ventricular ejection fraction; MEE, myocardial external efficiency; MVO2, myocardial oxygen consumption; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide; SympEF ≥50, symptomatic aortic valve stenosis patients with left ventricular ejection fraction ≥50%; SympEF <50, symptomatic aortic valve stenosis patients with left ventricular ejection fraction <50%.

• 

  Figure 2. Diagnostic accuracy to distinguish between asymptomatic and symptomatic aortic valve stenosis (AS) patients. Receiver operating characteristic curve analysis illustrating the diagnostic accuracy to distinguish between AS patients with and without symptoms. GLS vs MEE, GLS vs MVO2, and GSL vs LVEF, all P<0.05. GLS vs NT‐proBNP, P=0.10. Values are AUC (95% CI). AUC indicates area under the receiver operating characteristic curve; GLS, global longitudinal strain; LVEF, left ventricular ejection fraction; MEE, myocardial external efficiency; MVO2, myocardial oxygen consumption; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.

• 

  Figure 3. Reduced MEE and MVO2 in patients with paradoxical low‐flow low‐gradient aortic valve stenosis (AS). Reduced MEE in patients with P‐LFLG compared with AS patients with NFHG and NFLG AS. Mean±SD. *P<0.05 compared with NFHG and NFLG. MEE indicates myocardial external efficiency; MVO2, myocardial oxygen consumption; NFHG, normal‐flow, high‐gradient; NFLG, normal‐flow, low‐gradient; P‐LFLG, paradoxical low‐flow, low‐gradient aortic valve stenosis.