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IMPORTANCE OF AORTIC VALVE REPLACEMENT ON STROKE VOLUME INDEX IN LOW FLOW SEVERE AORTIC VALVE STENOSIS
A2000 JACC April 1, 2014 Volume 63, Issue 12
Valvular Heart Disease Importance of Aortic Valve Replacement on Stroke Volume Index in Low Flow Severe Aortic Valve Stenosis Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Clinical Posters Abstract Category: 28. Valvular Heart Disease: Clinical Presentation Number: 1232-343 Authors: Jordi S. Dahl, Kristian Wachtell, Lars Videbaek, Mikael K. Poulsen, Nicolaj Christensen, Rasmus Carter-Storch, Jacob Møller, Odense University Hospital, Odense, Denmark Background: A subgroup of patients with severe aortic stenosis (AS), have reduced stroke volume index (SVi) despite preserved ejection fraction. It is uncertain if SVi improves after aortic valve replacement (AVR). The purpose of this study was to evaluate the importance of AVR on SVi in patients with severe AS Methods: 125 patients with severe AS and ejection fraction >40% scheduled for AVR were evaluated preoperatively and followed with echocardiograms 3, 6 and 12 months postoperatively. Results: Eighty-two patients (66%) had normal flow defined as SVi ≥35ml/m2 and 43 had paradoxical low-flow defined as SVi <35ml/m2. Lowflow AS associated to smaller aortic valve area (0.7±0.2 vs. 0.9±0.3, p=0.001) and reduced global longitudinal strain (-14-2±3.6 vs. -17.1±3.3, p=0.002). After AVR, there was a significant increase in SVi (4±8 vs. -5±12 ml/m2, p=0.001) among patients with low-flow AS; patients with normal flow non-significantly decreased in SVi (49±10 vs. 43±9 ml/m2, p=0.11). However, 12 months after AVR, SVi was still significantly reduced in patients with low-flow AS compared to patients with normal flow (43±9 vs. 32±7 ml/m2, p=0.001). Conclusions: AVR resulted in increased SVi among patients with low-flow AS, whereas in patients presenting with normal-flow AS, AVR did not change SVi. AVR was associated with increase in postoperative functional capacity without an increased postoperative mortality in patients with lowflow compared to normal-flow patients with AS.
Valvular Heart Disease Importance of Aortic Valve Replacement on Stroke Volume Index in Low Flow Severe Aortic Valve Stenosis Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Clinical Posters Abstract Category: 28. Valvular Heart Disease: Clinical Presentation Number: 1232-343 Authors: Jordi S. Dahl, Kristian Wachtell, Lars Videbaek, Mikael K. Poulsen, Nicolaj Christensen, Rasmus Carter-Storch, Jacob Møller, Odense University Hospital, Odense, Denmark Background: A subgroup of patients with severe aortic stenosis (AS), have reduced stroke volume index (SVi) despite preserved ejection fraction. It is uncertain if SVi improves after aortic valve replacement (AVR). The purpose of this study was to evaluate the importance of AVR on SVi in patients with severe AS Methods: 125 patients with severe AS and ejection fraction >40% scheduled for AVR were evaluated preoperatively and followed with echocardiograms 3, 6 and 12 months postoperatively. Results: Eighty-two patients (66%) had normal flow defined as SVi ≥35ml/m2 and 43 had paradoxical low-flow defined as SVi <35ml/m2. Lowflow AS associated to smaller aortic valve area (0.7±0.2 vs. 0.9±0.3, p=0.001) and reduced global longitudinal strain (-14-2±3.6 vs. -17.1±3.3, p=0.002). After AVR, there was a significant increase in SVi (4±8 vs. -5±12 ml/m2, p=0.001) among patients with low-flow AS; patients with normal flow non-significantly decreased in SVi (49±10 vs. 43±9 ml/m2, p=0.11). However, 12 months after AVR, SVi was still significantly reduced in patients with low-flow AS compared to patients with normal flow (43±9 vs. 32±7 ml/m2, p=0.001). Conclusions: AVR resulted in increased SVi among patients with low-flow AS, whereas in patients presenting with normal-flow AS, AVR did not change SVi. AVR was associated with increase in postoperative functional capacity without an increased postoperative mortality in patients with lowflow compared to normal-flow patients with AS.