[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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