Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis
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 ejectio...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1555 |
| _version_ | 1797470562268741632 |
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| author | Federica Ilardi Adriana Postolache Raluca Dulgheru Mai-Linh Nguyen Trung Nils de Marneffe Tadafumi Sugimoto Yun Yun Go Cécile Oury Giovanni Esposito Patrizio Lancellotti |
| author_facet | Federica Ilardi Adriana Postolache Raluca Dulgheru Mai-Linh Nguyen Trung Nils de Marneffe Tadafumi Sugimoto Yun Yun Go Cécile Oury Giovanni Esposito Patrizio Lancellotti |
| author_sort | Federica Ilardi |
| collection | DOAJ |
| description | 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%, <i>p</i> < 0.001; GWW: 139 ± 90 vs. 90 ± 49 mmHg%, <i>p</i> = 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 (<i>p</i> = 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; <i>p</i> = 0.034) and GCW (HR:0.998, CI: 0.997–0.999; <i>p</i> = 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. |
| first_indexed | 2024-03-09T19:37:57Z |
| format | Article |
| id | doaj.art-d7a73d3662ad4b78a61a227dc898ed1a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:37:57Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d7a73d3662ad4b78a61a227dc898ed1a2023-11-24T01:48:12ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116155510.3390/jcm11061555Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic StenosisFederica Ilardi0Adriana Postolache1Raluca Dulgheru2Mai-Linh Nguyen Trung3Nils de Marneffe4Tadafumi Sugimoto5Yun Yun Go6Cécile Oury7Giovanni Esposito8Patrizio Lancellotti9Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumDepartment of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini, 5, 80131 Napoli, ItalyDepartment of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, BelgiumThis 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%, <i>p</i> < 0.001; GWW: 139 ± 90 vs. 90 ± 49 mmHg%, <i>p</i> = 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 (<i>p</i> = 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; <i>p</i> = 0.034) and GCW (HR:0.998, CI: 0.997–0.999; <i>p</i> = 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.https://www.mdpi.com/2077-0383/11/6/1555aortic stenosisasymptomaticmyocardial workcardiac damagestagingprognosis |
| spellingShingle | Federica Ilardi Adriana Postolache Raluca Dulgheru Mai-Linh Nguyen Trung Nils de Marneffe Tadafumi Sugimoto Yun Yun Go Cécile Oury Giovanni Esposito Patrizio Lancellotti Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis Journal of Clinical Medicine aortic stenosis asymptomatic myocardial work cardiac damage staging prognosis |
| title | Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis |
| title_full | Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis |
| title_fullStr | Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis |
| title_full_unstemmed | Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis |
| title_short | Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis |
| title_sort | prognostic value of non invasive global myocardial work in asymptomatic aortic stenosis |
| topic | aortic stenosis asymptomatic myocardial work cardiac damage staging prognosis |
| url | https://www.mdpi.com/2077-0383/11/6/1555 |
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