Relationship between left ventriculoarterial coupling and damage stage in severe aortic stenosis

Abstract Background In patients with severe aortic stenosis (AS), an anatomic and functional staging classification has been proposed to assess extent of cardiac chambers damage improve the decision valve replacement based only in symptoms or ejection fraction (EF) <50%. This relies on concept that left ventricular (LV) afterload secondary AS induce LV dysfunction progression right damage. However, valvular vascular components, latter is not evaluated by stages. Characteristics arterial vasculature can impact function through alteration LV-VA coupling which relationship between effective elastance (Ea) end-systolic (Emax). Objective To evaluate different stages AS. Methods We studied 205 patients, age average 70±11 years, 117 men, (AVA <1 cm2) Doppler echocardiography. Measurements were made according ASE/EACVI Guidelines. Ea was calculated as pressure divided stroke volume. End-systolic obtained from tonometry carotid pulse. Emax estimated method Senzaki (1) index contractility. / ratio used coupling. Patients five groups Tasted (2): stage 0, no damage; 1, (EF <60%); 2, atrial mitral 3, pulmonary tricuspid 4, damage, subclinical heart failure (LV volume <30 ml/m2). Results Mean ± standard deviation (see Table 1). No patient 0. Symptoms present 40% 85% 2 100% 3 4. increases 4 while did change those but decreased 1 2. Consequently, progressively Conclusions Worsening increase The due without significant changes level contractility appears be related disease also characteristics vasculature. Funding Acknowledgement Type funding sources: None.