1. Clinical significance of energy loss index in patients with low-gradient severe aortic stenosis and preserved ejection fraction
- Author
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Anne Ringle, Pierre Vladimir Ennezat, S. Maréchaux, Yohann Bohbot, Mesut Gun, Océane Bouchot, Alexandre Altes, Christophe Tribouilloy, Ludovic Appert, Raphaëlle A Guerbaai, Groupement Hospitalier de l'Institut Catholique de Lille, Faculté Libre de Médecine de Lille (FLM), Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-UC Lille, CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), University of Basel (Unibas), Service de cardiologie, and Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)
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medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,Body surface area ,Ejection fraction ,business.industry ,Hazard ratio ,Mean Aortic Pressure ,Stroke Volume ,Aortic Valve Stenosis ,General Medicine ,medicine.disease ,Stenosis ,Treatment Outcome ,Aortic Valve ,Aortic valve stenosis ,Aortic pressure ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Aims We hypothesized that among patients with low-gradient severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF), reclassification of AS severity as moderate by pressure recovery adjusted indexed aortic valve area (AVAi) = energy loss index (ELI), may identify a subgroup of patients with a better outcome. Methods and results Three hundred and seventy-nine patients with low-gradient AS (defined by AVAi ≤ 0.6 cm2/m2 and mean aortic pressure gradient 0.6 cm2/m2. Cardiac events [cardiac mortality and/or need for aortic valve replacement (AVR)] during follow-up were studied. One hundred and forty-eight patients (39%) were reclassified as moderate AS by ELI. Reclassification as moderate AS was independently associated with decreased body surface area, normal flow status, decreased left ventricular mass index, and left atrial volume index (all P Conclusion In patients with low-gradient severe AS and preserved LVEF, calculation of ELI permits to reclassify almost 40% of patients as having moderate AS. These reclassified patients have a considerable reduction of the risk of cardiac events during follow-up. Calculation of ELI is useful for decision-making in patients with low-gradient severe AS and preserved ejection fraction.
- Published
- 2020
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