Author + information
- Nicholas Ngiam,
- Benjamin Tan,
- Ching-Hui Sia,
- Hui-Wen Sim,
- Elaine Boey,
- William K.F. Kong,
- Tiong Cheng Yeo and
- Kian Keong Poh
Background: Paradoxical low-flow (LF) severe aortic stenosis (AS) with preserved left ventricular ejection fraction (LVEF) may have a worse prognosis compared to normal-flow (NF) but its pathophysiology remained unclear. Conventionally LV stiffness measurement required invasive pressure-volume loop (PVL) analysis. However, we aim to apply a novel echocardiographic index of LV stiffness in patients with LF versus NF severe AS.
Methods: Consecutive patients (n=352) with severe AS (aortic valve area<1cm2) and LVEF>50% were studied by conventional echocardiography and tissue Doppler imaging. LV stiffness was measured by E:E'(lateral mitral annular) / LV end-diastolic volume, an index validated against PVL. We compared the LF (stroke volume index, SVI<35ml/m2), vs NF.
Results: There were 121 (34%) with LF. Both flow groups had similar demographics, valve areas and parameters (Table). LV stiffness index was higher in LF and correlated with a lower left ventricular mass index. Patients with LV concentric remodelling and hypertrophy had higher LV stiffness compared to the other patterns of LV remodelling, especially in those with low-flow.
Conclusions: LV stiffness was significantly higher in patients with LF severe AS, and was related to the development of LV concentric remodelling and hypertrophy. This may be associated with poorer outcomes in LF. Further studies are warranted.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: New Technologies in Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1245-211
- 2017 American College of Cardiology Foundation