Echocardiographic findings on aortic stenosis: an observational, prospective, and multi-center registry
Journal
Perfusion
Date Issued
2020-07-10
Author(s)
Shehab Anwer
Didem Oğuz
Laura Galian Gay
Lilit Baghdassarian
Raluca Dulgheru
Tomas Lapinskas
Ciro Santoro
Savvas Loizos
Matteo Cameli
Julia Grapsa
Julien Magne
Erwan Donal
DOI
DOI: 10.1177/0267659120924921
Abstract
Background: The aim of this aortic stenosis registry was to investigate the changes of routine echocardiographic indices
and strain in patients with moderate-to-severe aortic stenosis over a 6-month follow-up period.
Methods: Our aortic stenosis registry is observational, prospective, multicenter registry of nine countries, with 197
patients with aortic valve area less than 1.5 cm2. The enrolment took place from January to August 2017. We excluded
patients with uncontrolled atrial arrhythmias, pulmonary hypertension or cardiomyopathies, as well as those with
hemodynamically significant valvular disease other than aortic stenosis. We included patients who did not require
intervention and who had a complete follow-up study.
Results: In patients with preserved ejection fraction, left ventricular mass has significantly increased between baseline and
follow-up studies (218 ± 34 grams vs 253 ± 29 grams, p = 0.02). However, when indexed to body surface area, there was
no significant difference. Left ventricular global longitudinal strain significantly decreased (-19.7 ± -4.8 vs (-16.4 vs -3.8,
p = 0.01). Left atrial volume was significantly higher at follow-up (p = 0.035). Right ventricular basal diameter and midcavity
diameter were greater at the follow-up (p = 0.04 and p = 0.035, respectively). Patients with low-flow low-gradient
aortic stenosis had significantly lower global longitudinal strain (-12.3% ± -3.9% vs -19.7% ± -4.8%, p = 0.01).
Conclusion: Left atrial dilatation is one of the first changes to take place in low-flow low-gradient aortic stenosis patients
even when left ventricular dimensions and function remains intact. Global longitudinal strain is an important determinant
of left ventricular systolic and diastolic dysfunction and right ventricular function is an important parameter of aortic
stenosis assessment. Accordingly, our registry has further shed the light on these indices role as multisite follow-up of
aortic stenosis.
and strain in patients with moderate-to-severe aortic stenosis over a 6-month follow-up period.
Methods: Our aortic stenosis registry is observational, prospective, multicenter registry of nine countries, with 197
patients with aortic valve area less than 1.5 cm2. The enrolment took place from January to August 2017. We excluded
patients with uncontrolled atrial arrhythmias, pulmonary hypertension or cardiomyopathies, as well as those with
hemodynamically significant valvular disease other than aortic stenosis. We included patients who did not require
intervention and who had a complete follow-up study.
Results: In patients with preserved ejection fraction, left ventricular mass has significantly increased between baseline and
follow-up studies (218 ± 34 grams vs 253 ± 29 grams, p = 0.02). However, when indexed to body surface area, there was
no significant difference. Left ventricular global longitudinal strain significantly decreased (-19.7 ± -4.8 vs (-16.4 vs -3.8,
p = 0.01). Left atrial volume was significantly higher at follow-up (p = 0.035). Right ventricular basal diameter and midcavity
diameter were greater at the follow-up (p = 0.04 and p = 0.035, respectively). Patients with low-flow low-gradient
aortic stenosis had significantly lower global longitudinal strain (-12.3% ± -3.9% vs -19.7% ± -4.8%, p = 0.01).
Conclusion: Left atrial dilatation is one of the first changes to take place in low-flow low-gradient aortic stenosis patients
even when left ventricular dimensions and function remains intact. Global longitudinal strain is an important determinant
of left ventricular systolic and diastolic dysfunction and right ventricular function is an important parameter of aortic
stenosis assessment. Accordingly, our registry has further shed the light on these indices role as multisite follow-up of
aortic stenosis.
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Echocardiographic findings on aortic stenosis: an observational, prospective, and multi-center registry
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