[en] This study aimed to evaluate the modification of non-invasive myocardial work (MW) indices related to aortic stenosis (AS) stages of cardiac damage and their prognostic value. The echocardiographic and outcome data of 170 patients, with asymptomatic moderate-to-severe AS and left ventricular ejection fraction (LVEF) ≥ 50%, and 50 age- and sex-comparable healthy controls were analysed. Primary endpoints were the occurrence of all-cause and cardiovascular death. Increased values of the global work index (GWI), global constructive work (GCW), and global wasted work (GWW) were observed in AS patients compared to controls (GWI: 2528 ± 521 vs. 2005 ± 302 mmHg%, GCW: 2948 ± 598 vs. 2360 ± 353 mmHg%, p < 0.001; GWW: 139 ± 90 vs. 90 ± 49 mmHg%, p = 0.005), with no changes in the global work efficiency. When patients were stratified according to the stages of cardiac damage, the GWI showed lower values in Stage 3-4 as compared to Stage 0 and Stage 2 (p = 0.024). During a mean follow-up of 30 months, 27 patients died. In multivariable Cox-regression analysis, adjusted for confounders, GWI (HR: 0.998, CI: 0.997-1.000; p = 0.034) and GCW (HR:0.998, CI: 0.997-0.999; p = 0.003) were significantly associated with excess mortality. When used as categorical variables, a GWI ≤ 1951 mmHg% and a GCW ≤ 2475 mmHg% accurately predicted all-cause and cardiovascular death at 4-year follow-up. In conclusion, in asymptomatic patients with moderate-to-severe AS, reduced values of GWI and GCW are associated with increased mortality. Therefore, the evaluation of MW indices may allow for a better identification of asymptomatic patients with moderate to severe AS and preserved LVEF whom are at increased risk of worse prognosis during follow-up.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Ilardi, Federica ; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart ; Department of Advanced Biomedical Sciences, Federico II University Hospital, Via
Postolache, Adriana ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie ; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart
Dulgheru, Raluca; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart
Trung, Mai-Linh Nguyen; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart
DE MARNEFFE, Nils ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie ; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman
Sugimoto, Tadafumi ; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart ; Clinical Laboratory, Mie University Hospital, Tsu 514-8507, Japan.
Go, Yun Yun; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart ; Department of Cardiology, National Heart Research Institute Singapore, National
Oury, Cécile ; Université de Liège - ULiège > GIGA > GIGA Cardiovascular Sciences - Cardiology ; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart
Esposito, Giovanni; Department of Advanced Biomedical Sciences, Federico II University Hospital, Via
LANCELLOTTI, Patrizio ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie ; Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart ; Gruppo Villa Maria Care and Research, Anthea Hospital, 70124 Bari, Italy.
Language :
English
Title :
Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Vahanian, A.; Beyersdorf, F.; Praz, F.; Milojevic, M.; Baldus, S.; Bauersachs, J.; Capodanno, D.; Conradi, L.; De Bonis, M.; De Paulis, R.; et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur. Heart J. 2021, 43, ehab395.
Lancellotti, P.; Magne, J.; Dulgheru, R.; Clavel, M.A.; Donal, E.; Vannan, M.A.; Chambers, J.; Rosenhek, R.; Habib, G.; Lloyd, G.; et al. Outcomes of Patients with Asymptomatic Aortic Stenosis Followed up in Heart Valve Clinics. JAMA Cardiol. 2018, 3, 1060– 1068.
Strange, G.; Stewart, S.; Celermajer, D.; Prior, D.; Scalia, G.M.; Marwick, T.; Ilton, M.; Joseph, M.; Codde, J.; Playford, D. Poor long-term survival in patients with moderate aortic stenosis. J. Am. Coll. Cardiol. 2019, 74, 1851–1863.
Tastet, L.; Tribouilloy, C.; Maréchaux, S.; Vollema, E.M.; Delgado, V.; Salaun, E.; Shen, M.; Capoulade, R.; Clavel, M.-A.; Arsenault, M.; et al. Staging Cardiac Damage in Patients with Asymptomatic Aortic Valve Stenosis. J. Am. Coll. Cardiol. 2019, 74, 550–563.
Ilardi, F.; D’Andrea, A.; D’Ascenzi, F.; Bandera, F.; Benfari, G.; Esposito, R.; Malagoli, A.; Mandoli, G.E.; Santoro, C.; Russo, V.; et al. Myocardial Work by Echocardiography: Principles and Applications in Clinical Practice. J. Clin. Med. 2021, 10, 4521.
Manganaro, R.; Marchetta, S.; Dulgheru, R.; Ilardi, F.; Sugimoto, T.; Robinet, S.; Cimino, S.; Go, Y.Y.; Bernard, A.; Kacharava, G.; et al. Echocardiographic reference ranges for normal non-invasive myocardial work indices: Results from the EACVI NORRE study. Eur. Heart J. Cardiovasc. Imaging 2019, 20, 582–590.
Baumgartner, H.; Hung, J.; Bermejo, J.; Chambers, J.B.; Edvardsen, T.; Goldstein, S.; Lancellotti, P.; LeFevre, M.; Miller, F., Jr.; Otto, C.M. Recommendations on the echocardiographic assessment of aortic valve stenosis: A focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur. Heart J. Cardiovasc. Imaging 2017, 18, 254–275.
Briand, M.; Dumesnil, J.G.; Kadem, L.; Tongue, A.G.; Rieu, R.; Garcia, D.; Pibarot, P. Reduced systemic arterial compliance impacts significantly on left ventricular afterload and function in aortic stenosis: Implications for diagnosis and treatment. J. Am. Coll. Cardiol. 2005, 46, 291–298.
de Simone, G.; Chinali, M.; Galderisi, M.; Benincasa, M.; Girfoglio, D.; Botta, I.; DʹAddeo, G.; de Divitiis, O. Myocardial mechano-energetic efficiency in hypertensive adults. J. Hypertens 2009, 27, 650–655.
Ilardi, F.; Marchetta, S.; Martinez, C.; Sprynger, M.; Ancion, A.; Manganaro, R.; Sugimoto, T.; Tsugu, T.; Postolache, A.; Piette, C.; et al. Impact of aortic stenosis on layer-specific longitudinal strain: Relationship with symptoms and outcome. Eur. Heart J. Cardiovasc. Imaging 2019, 21, 408–416.
Russell, K.; Eriksen, M.; Aaberge, L.; Wilhelmsen, N.; Skulstad, H.; Remme, E.W.; Huagaa, K.H.; Opdahl, A.; Fjeld, J.G.; Gjesdal, O.; et al. A novel clinical method for quantification of regional left ventricular pressure-strain loop area: A non-invasive index of myocardial work. Eur. Heart J. 2012, 33, 724–733.
Jain, R.; Bajwa, T.; Roemer, S.; Huisheree, H.; Allaqaband, S.Q.; Kroboth, S.; Moreno, A.C.P.; Tajik, A.J.; Khandheria, B.K. Myocardial work assessment in severe aortic stenosis undergoing transcatheter aortic valve replacement. Eur. Heart J. Cardiovasc. Imaging 2021, 22, 715–721.
Fortuni, F.; Butcher, S.C.; van der Kley, F.; Lustosa, R.P.; Karalis, I.; de Weger, A.; Priori, S.G.; van der Bijl, P.; Bax, J.J.; Delgado, V.; et al. Left Ventricular Myocardial Work in Patients with Severe Aortic Stenosis. J. Am. Soc. Echocardiogr. 2021, 34, 257–266.
Henkel, D.M.; Malouf, J.F.; Connolly, H.M.; Michelena, H.I.; Sarano, M.E.; Schaff, H.V.; Scott, C.; Pellikka, P.A. Asymptomatic left ventricular systolic dysfunction in patients with severe aortic stenosis: Characteristics and outcomes. J. Am. Coll. Cardiol. 2012, 60, 2325–2329.
Potter, E.; Marwick, T.H. Assessment of Left Ventricular Function by Echocardiography: The Case for Routinely Adding Global Longitudinal Strain to Ejection Fraction. JACC Cardiovasc. Imaging 2018, 11, 260–274.
Magne, J.; Cosyns, B.; Popescu, B.A.; Carstensen, H.G.; Dahl, J.; Desai, M.Y.; Kearney, L.; Lancellotti, P.; Marwick, T.H.; Sato, K.; et al. Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis. JACC Cardiovasc. Imaging 2019, 12, 84–92.
Reant, P.; Metras, A.; Detaille, D.; Reynaud, A.; Diolez, P.; Jaspard-Vinassa, B.; Roudaut, R.; Ouattara, A.; Barandon, L.; Dos Santos, P.; et al. Impact of afterload increase on left ventricular myocardial deformation indices. J. Am. Soc. Echocardiogr 2016, 29, 1217–1228.
D’Andrea, A.; Ilardi, F.; D’Ascenzi, F.; Bandera, F.; Benfari, G.; Esposito, R.; Malagoli, A.; Mandoli, G.E.; Santoro, C.; Russo, V.; et al. Impaired myocardial work efficiency in heart failure with preserved ejection fraction. Eur. Heart J. Cardiovasc. Imaging 2021, 22, 1312–1320.
Chan, J.; Edwards, N.F.A.; Khandheria, B.K.; Shiino, K.; Sabapathy, S.; Anderson, B.; Chamberlain, R.; Scalia, G.M. A new approach to assess myocardial work by non-invasive left ventricular pressure-strain relations in hypertension and dilated cardiomyopathy. Eur. Heart J. Cardiovasc. Imaging 2019, 20, 31–39.
Avvedimento, M.; Franzone, A.; Leone, A.; Piccolo, R.; Castiello, D.S.; Ilardi, F.; Mariani, A.; Esposito, R.; Iapicca, C.; Angellotti, D.; et al. Extent of Cardiac Damage and Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation. J. Clin. Med. 2021, 10, 4563.
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.