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Kardiologie up2date 2014; 10(01): 14-19
DOI: 10.1055/s-0034-1365305
Hotline – Aortenerkrankungen
© Georg Thieme Verlag KG Stuttgart · New York

Energy Loss Index bei Niedriggradientenaortenstenosen mit normaler linksventrikulärer Funktion

Edda Bahlmann
,
Karl Heinz Kuck
,
Christoph A. Nienaber
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Publication History

Publication Date:
10 April 2014 (online)

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Abstract

Therapeutic decisions in AS patients are based on presence of symptoms and echocardiographic assessment of hemodynamic severity. Accurate evaluation of AS severity is therefore of major clinical importance. Pressure recovery in the aortic root influences the assessment of AS severity. Overestimation of AS severity by for pressure recovery unadjusted aortic valve area index (AVAI) is largest in patients with small aortic roots or low peak aortic jet velocity. The percentage of reclassification from severe AS to non-severe AS by pressure recovery adjustment of AVAI (Energy loss index [ELI]) may be up to 45,7 %. It was recently demonstrated in asymptomatic AS patients that ELI provides better risk classification than conventional measures of AS severity, including peak aortic jet velocity and mean aortic gradient. In particular ELI improved prediction of combined mortality and hospitalization for heart failure in AS patients with small aortic roots. These novel findings suggest that calculation of ELI should be included in routine assessment of AS severity.

 

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