[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.
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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.
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