Incremental value of myocardial work in predicting beneficial response to aortic valve replacement in patients with aortic stenosis

Abstract The predictors of favorable clinical response to aortic valve replacement (AVR) in stenosis (AS) are still insufficiently defined. increased LV afterload AS affects the interpretation majority systolic indices, which load-dependent. estimation myocardial work (MW) is a newly developed approach, which, allowing correction global longitudinal strain (GLS) for afterload, gives more adequate insight into intrinsic contractility. Aim To investigate whether assessment MW can improve prediction and neurohormonal improvement post AVR patients with AS. Methods We evaluated 126 (75±9 years) severe who underwent transcatheter (n=100) or surgical (n=26). Transthoracic echocardiography, blood sampling 6 min walk test (6MWT) were performed pre 3 months AVR. following indices assessed: index (GWI), constructive (GCW), wasted (GWW), efficiency (GWE). Results Post-AVR changes echocardiographic profile presented Table. Post-treatment increase 6MWT distance was noted 95 patients, decrease NT-proBNP 94 patients. In multivariable analysis including parameters cardiac function, morphology hemodynamic, baseline GWW only independent predictor post-AVR (beta=−0.24, SE 0.09, p=0.01), whereas GWE was, addition tricuspid regurgitation pressure gradient (TRPG) E/e' ratio, independently associated (beta=0.27, p=0.004). Conclusions undergoing AVR, higher values do not favor post-treatment functional as assessed by 6MWT. beneficial pronounced less efficient contraction at baseline. Funding Acknowledgement Type funding sources: None.