1. Echocardiographic findings on aortic stenosis: an observational, prospective, and multi-center registry
- Author
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Tomas Lapinskas, Didem Oguz, Elizabeta Srbinovska, Shehab Anwer, Erwan Donal, Irena Peovska Mitevska, Matteo Cameli, Lilit Baghdassarian, Laura Galian-Gay, Ciro Santoro, Raluca Elena Dulgheru, Savvas Loizos, Julien Magne, Julia Grapsa, Department of Cardiology, University Heart Center, University Hospital Zurich, Başkent University Hospital [Adana, Turkey], Department of Cardiovascular Medicine, Mayo Clinic, Hospital General Universitari Vall dHebron, University of Skopje, Yerevan State Medical University, GIGA Cardiovascular Sciences [Liège, Belgium] (Department of Cardiology), University Hospital Sart Tilman [Liège, Belgium]-Heart Valve Clinic [Liège, Belgium], Lithuanian University of health Sciences [Kaunas], University of Naples Federico II, Hammersmith Hospital NHS Imperial College Healthcare, Università degli Studi di Siena = University of Siena (UNISI), Barts Health NHS Trust [London, UK], Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie [CHU Limoges], CHU Limoges, Centre Hospitalier Universitaire de Rennes (CHU Rennes), Clinical sciences, Anwer, S., Oguz, D., Galian-Gay, L., Peovska Mitevska, I., Baghdassarian, L., Dulgheru, R., Lapinskas, T., Santoro, C., Loizos, S., Cameli, M., Srbinovska, E., Grapsa, J., Magne, J., and Donal, E.
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medicine.medical_specialty ,Aortic Valve Stenosis/diagnostic imaging ,left ventricle ,030204 cardiovascular system & hematology ,right ventricle ,Severity of Illness Index ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,strain ,Internal medicine ,Medicine ,Humans ,echocardiography ,Radiology, Nuclear Medicine and imaging ,In patient ,030212 general & internal medicine ,Low gradient ,Prospective Studies ,Registries ,Advanced and Specialized Nursing ,business.industry ,aortic stenosis ,Stroke Volume ,General Medicine ,Aortic Valve Stenosis ,aortic stenosi ,medicine.disease ,Stenosis ,volumes ,Aortic valve stenosis ,Cardiology ,cardiovascular system ,Observational study ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,low flow low gradient ,Cardiology and Cardiovascular Medicine ,business ,Safety Research ,Follow-Up Studies - 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 mid-cavity 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.
- Published
- 2021
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