Role of Exercise Testing and Speckle Tracking Echocardiography in Paradoxical Severe Aortic Stenosis
| Autor: | Alejandro Jiménez Sosa, Amelia Duque-González, Belén Marí-López, Flor Baeza-Garzón, Ignacio Laynez-Cerdeña, Juan Lacalzada-Almeida, Leopoldo Pérez de Isla, María Manuela Izquierdo-Gómez |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
exercise testing business.industry General Engineering Cardiology Speckle tracking echocardiography speckle tracking imaging Odds ratio medicine.disease left ventricular strain Asymptomatic Confidence interval body regions Stenosis paradoxical aortic stenosis medicine.anatomical_structure Ventricle Internal medicine Cohort medicine echocardiography medicine.symptom business Speckle tracking imaging |
| Zdroj: | Cureus |
| DOI: | 10.21203/rs.3.rs-113917/v1 |
| Popis: | Background The clinical behavior and prognosis of patients with asymptomatic paradoxical low-gradient aortic stenosis (PLGAS) still remain controversial. Some authors consider PLGAS as an echocardiographically poorly quantified moderate AS (MAS). We aimed to investigate the clinical behavior of PLGAS by comparing it with that of asymptomatic high-gradient aortic stenosis (HG-AS) and MAS using transthoracic echocardiography (TTE) with speckle tracking imaging (STI) and cardiopulmonary exercise testing (CPET).Methods A cohort of 113 patients was included and categorized into three groups according to AS type: MAS (n=63), HG-AS (n=29), and PLGAS (n=21). Patients’ clinical data were obtained. Patients underwent 2D TTE with STI and CPET. Results There were no significant differences in the clinical variables between the three AS groups. In the multivariate multinomial logistic regression analysis, with PLGAS being the reference category, the most powerful variable for establishing a difference with HG-AS was the left ventricular mass (LVM) indexed by body-surface area (odds ratio [OR]=1.04, confidence interval [CI]=1.01-1.06, pConclusions TTE with STI and CPET established the clear differences between patients with asymptomatic PLGAS and those with asymptomatic MAS, as well as the similarities between patients with PLGAS and those with HG-AS. Our data identifies PLGAS as a completely different entity from MAS. |
| Databáze: | OpenAIRE |
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