Relationship of contractile state to ejection performance in patients with chronic aortic valve disease.
Key result
Chronic aortic valve disease was associated with depressed ejection fractions (0.56 and 0.53 vs 0.69 in controls; p<0.05) disproportionate to the mild degree of afterload mismatch.
Why the study?
What are the relative contributions of afterload mismatch and impaired contractility to pump dysfunction in patients with chronic aortic valve disease?
Population
56 patients: 21 with severe aortic stenosis, 16 with severe aortic regurgitation, and 19 normal control…
Comparison
Simultaneous left ventricular cineangiography… vs Normal control subjects
Design
Cross-sectional
Authors
Discussion
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Implication
Afterload mismatch may predominate in aortic valve pump failure; leaves open whether contractility metrics should refine valve intervention timing.
Study Design
Type
Cross-Sectional (n=56)
Structured PICO
What are the relative contributions of afterload mismatch and impaired contractility to pump dysfunction in patients with chronic aortic valve disease?
P
Population
56 subjects, comprising 21 with severe aortic stenosis, 16 with severe aortic regurgitation, and 19 normal controls, assessed for left ventricular pump dysfunction.
E
Exposure
Simultaneous left ventricular cineangiography and micromanometry
C
Comparator
Normal control subjects
O
Outcome
Pump dysfunction (assessed via ejection fraction and end-systolic stress)surrogate
Main Result
p-value: p=<0.05
In patients with chronic severe aortic valve disease, depressed ejection fraction is disproportionate to afterload mismatch, indicating that impaired myocardial contractility plays a significant role in pump dysfunction.
Cite This Study
Wisenbaugh et al. (1986) conducted a cross-sectional in Chronic aortic valve disease (n=56). Chronic aortic valve disease (severe aortic stenosis or regurgitation) vs. Normal control subjects was evaluated on Ejection fraction (p=<0.05). Chronic aortic valve disease was associated with depressed ejection fractions (0.56 and 0.53 vs 0.69 in controls; p<0.05) disproportionate to the mild degree of afterload mismatch.