Paradoxical low-flow aortic stenosis is defined by increased ventricular hydraulic load and reduced longitudinal strain

Anthony A. Holmes, Cynthia C. Taub, Mario J. Garcia, Jian Shan, David P. Slovut

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Abstract

AIMS: Patients with paradoxical low-flow severe aortic stenosis (PLF-AS) reportedly have higher left ventricular hydraulic load and more systolic strain dysfunction than patients with normal-flow aortic stenosis. This study investigates the relationship of systolic loading and strain to PLF-AS to further define its pathophysiology. METHODS: One hundred and twenty patients (age 79?±?12?years, 37% men) with an indexed aortic valve area (AVAi) of 0.6?cm/m or less and an ejection fraction of 50% or higher were divided into two groups based on indexed stroke volume (SVi): PLF-AS, SVi ≤ 35?ml/m, N?=?46; normal-flow aortic stenosis, SVi > 35?ml/m, N?=?74). Valvular and arterial load were assessed using multiple measurements, and strain was assessed using speckle-tracking echocardiography. RESULTS: Patients with PLF-AS were found to have more valvular load (lower AVAi, P?=?0.028; lower energy loss coefficient, P?=?0.001), more arterial load [decreased arterial compliance and increased systemic vascular resistance (SVR), both P?

Original languageEnglish (US)
JournalJournal of Cardiovascular Medicine
DOIs
StateAccepted/In press - Nov 7 2015

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Aortic Valve Stenosis
Aortic Valve
Vascular Resistance
Stroke Volume
Compliance
Echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{564bf68b9d25463ba99be45c62d2f0ca,
title = "Paradoxical low-flow aortic stenosis is defined by increased ventricular hydraulic load and reduced longitudinal strain",
abstract = "AIMS: Patients with paradoxical low-flow severe aortic stenosis (PLF-AS) reportedly have higher left ventricular hydraulic load and more systolic strain dysfunction than patients with normal-flow aortic stenosis. This study investigates the relationship of systolic loading and strain to PLF-AS to further define its pathophysiology. METHODS: One hundred and twenty patients (age 79?±?12?years, 37{\%} men) with an indexed aortic valve area (AVAi) of 0.6?cm/m or less and an ejection fraction of 50{\%} or higher were divided into two groups based on indexed stroke volume (SVi): PLF-AS, SVi ≤ 35?ml/m, N?=?46; normal-flow aortic stenosis, SVi > 35?ml/m, N?=?74). Valvular and arterial load were assessed using multiple measurements, and strain was assessed using speckle-tracking echocardiography. RESULTS: Patients with PLF-AS were found to have more valvular load (lower AVAi, P?=?0.028; lower energy loss coefficient, P?=?0.001), more arterial load [decreased arterial compliance and increased systemic vascular resistance (SVR), both P?",
author = "Holmes, {Anthony A.} and Taub, {Cynthia C.} and Garcia, {Mario J.} and Jian Shan and Slovut, {David P.}",
year = "2015",
month = "11",
day = "7",
doi = "10.2459/JCM.0000000000000324",
language = "English (US)",
journal = "Journal of Cardiovascular Medicine",
issn = "1558-2027",
publisher = "Lippincott Williams and Wilkins",

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TY - JOUR

T1 - Paradoxical low-flow aortic stenosis is defined by increased ventricular hydraulic load and reduced longitudinal strain

AU - Holmes, Anthony A.

AU - Taub, Cynthia C.

AU - Garcia, Mario J.

AU - Shan, Jian

AU - Slovut, David P.

PY - 2015/11/7

Y1 - 2015/11/7

N2 - AIMS: Patients with paradoxical low-flow severe aortic stenosis (PLF-AS) reportedly have higher left ventricular hydraulic load and more systolic strain dysfunction than patients with normal-flow aortic stenosis. This study investigates the relationship of systolic loading and strain to PLF-AS to further define its pathophysiology. METHODS: One hundred and twenty patients (age 79?±?12?years, 37% men) with an indexed aortic valve area (AVAi) of 0.6?cm/m or less and an ejection fraction of 50% or higher were divided into two groups based on indexed stroke volume (SVi): PLF-AS, SVi ≤ 35?ml/m, N?=?46; normal-flow aortic stenosis, SVi > 35?ml/m, N?=?74). Valvular and arterial load were assessed using multiple measurements, and strain was assessed using speckle-tracking echocardiography. RESULTS: Patients with PLF-AS were found to have more valvular load (lower AVAi, P?=?0.028; lower energy loss coefficient, P?=?0.001), more arterial load [decreased arterial compliance and increased systemic vascular resistance (SVR), both P?

AB - AIMS: Patients with paradoxical low-flow severe aortic stenosis (PLF-AS) reportedly have higher left ventricular hydraulic load and more systolic strain dysfunction than patients with normal-flow aortic stenosis. This study investigates the relationship of systolic loading and strain to PLF-AS to further define its pathophysiology. METHODS: One hundred and twenty patients (age 79?±?12?years, 37% men) with an indexed aortic valve area (AVAi) of 0.6?cm/m or less and an ejection fraction of 50% or higher were divided into two groups based on indexed stroke volume (SVi): PLF-AS, SVi ≤ 35?ml/m, N?=?46; normal-flow aortic stenosis, SVi > 35?ml/m, N?=?74). Valvular and arterial load were assessed using multiple measurements, and strain was assessed using speckle-tracking echocardiography. RESULTS: Patients with PLF-AS were found to have more valvular load (lower AVAi, P?=?0.028; lower energy loss coefficient, P?=?0.001), more arterial load [decreased arterial compliance and increased systemic vascular resistance (SVR), both P?

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