Abstract 12776: Novel Left Ventricle Contractility Index as a Marker of Left Ventricular Function in Aortic Stenosis

Abstract

Introduction: The maximal rate of change of pressure-normalized wall stress dσ*/dt max is a novel, non-invasive, load-independent index of left ventricular (LV) global contractility. We aim to evaluate the relationship between dσ*/dt max and aortic stenosis (AS). Methods: 417 patients with severe AS (aortic valve area [AVA] <1cm 2 ) and no more than moderate concomitant other valvular pathology underwent echocardiography to characterise LV dimension, structure and dσ*/dt max . Univariate and multivariate analyses were performed. Results: Critical and non critical severe AS were defined as AVA≤0.8cm 2 and AVA≤1.0cm 2 respectively. Univariate analysis is presented in Table 1. dσ*/dt max was reduced in subjects with critical severe AS compared to non-critical severe AS (2.17± 0.79s-1 vs 2.46 ± 0.82s-1, p<0.001). Furthermore, dσ*/dt max was found to correlate with other indices of AS severity. Multivariate analysis showed that dσ*/dt max correlated with indexed AVA (B=0.20, p<0.001), LV ejection fraction (B=0.154, p<0.001), cardiac output (B=0.377, p<0.001) and LV mass index (B=-0.664, p<0.001). dσ*/dt max did not co-relate with age, gender, body mass index or body surface area. Conclusions: dσ*/dt max correlates with indices of AS severity and may be a reflection of underlying LV dysfunction in severe AS.