Does effort intolerance predict cardiac death and heart failure-related rehospitalization in patients with asymptomatic/minimally symptomatic aortic stenosis?
Effort intolerance, driven by aortic stenosis severity and extra-aortic cardiac injuries, is associated with higher cardiac death and heart failure rehospitalization in asymptomatic or minimally symptomatic patients.
BACKGROUND: We aimed to investigate the prevalence and prognostic impact of effort intolerance in patients with asymptomatic/minimally symptomatic aortic stenosis and to study its determinants. METHODS AND RESULTS: =0.01) were all associated with effort intolerance. A Strain Index was determined as a sum of points based on receiver operator characteristics analysis: left ventricular global longitudinal strain >17.2%, 15.7% to 17.2%, and 25.5%, 20.7 to 25.5%, and 22.5%, 17.2 to 22.5%, and 4.17 mm Hg/min per L were also significantly associated with effort intolerance. Significantly higher cardiac death and heart failure-related rehospitalization were observed in the effort-intolerance group. CONCLUSIONS: Both aortic stenosis severity and extra-aortic cardiac injuries lead to effort intolerance. Strain Index and exercise indices such as tricuspid annular plane systolic excursion versus systolic pulmonary artery pressure and mean pulmonary artery pressure versus cardiac output slopes may be valuable for risk stratification in minimally symptomatic/asymptomatic aortic stenosis.
Hamada et al. (Tue,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: