Low ejection fraction high-gradient severe aortic stenosis was associated with significantly higher end-systolic wall stress compared to normal ejection fraction (265.3 vs 122.8; p<0.0001).
Cross-Sectional (n=48)
No
What are the morphological and functional differences in left ventricular remodeling between low ejection fraction and normal ejection fraction high-gradient severe aortic stenosis?
In severe aortic stenosis with afterload mismatch, reduced LVEF is associated with high end-systolic wall stress driven by LV cavity dilation and smaller valve areas, rather than insufficient concentric hypertrophy.
Absolute Event Rate: 265.3% vs 122.8%
p-value: p=<0.0001
Objectives This study aimed to investigate the relationship between left ventricular (LV) remodelling and systolic function in high-gradient severe aortic stenosis (AS) using cardiovascular magnetic resonance (CMR) imaging. Patients with low ejection fraction (left ventricular ejection fraction (LVEF) 0.99) was identical between the groups. The LV mass index was numerically higher in the LEF-HG group (101.9±37.2 vs 77.6±22.2 g/m 2 ) but this was not statistically significant (p=0.91). The LEF-HG AS group demonstrated significant LV cavity dilation (LV End-Diastolic Volume Index 124.9±29.9 vs 78.4±16.0 mL/m 2 , p<0.0001). Elevated ESWS was associated with smaller valve areas and cavity dilation but not with LVH. Conclusion The reduced LVEF in afterload mismatch was associated with high ESWS as previously suggested. However, insufficient concentric LVH was not observed in LEF-HG AS and therefore not associated with high ESWS. LV cavity dilation and smaller valve areas were instead associated with the elevated ESWS in afterload mismatch, which may represent the decompensated stage of high-gradient severe AS.
Rajah et al. (Mon,) conducted a cross-sectional in High-gradient severe aortic stenosis (n=48). Low ejection fraction (LVEF <50%) vs. Normal ejection fraction was evaluated on End-systolic wall stress (ESWS) (p=<0.0001). Low ejection fraction high-gradient severe aortic stenosis was associated with significantly higher end-systolic wall stress compared to normal ejection fraction (265.3 vs 122.8; p<0.0001).
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