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Impact of stroke volume on severe aortic stenosis in patients with normal left ventricular function

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Abstract

Background

Low-flow (LF) aortic stenosis (AS) with a normal ejection fraction reportedly has a worse prognosis than normal-flow (NF) AS. We assessed whether the stroke volume affects early- and long-term survival of patients with AS undergoing aortic valve replacement.

Methods and results

From 2007 to 2016, 179 patients with AS and a normal ejection fraction (≥ 50%) and without other valve diseases were divided into two groups according to the stroke volume index (SVI): NF group (SVI ≥ 35 ml/m2, n = 167) and LF group (SVI < 35 ml/m2, n = 12). Early- and long-term survival was compared between the two groups. Preoperative echocardiography showed that the end-diastolic diameter and aortic valve area were smaller in the LF than NF group (43 ± 1.9 vs. 48 ± 0.4 mm, p < 0.005 and 0.33 ± 0.14 vs. 0.49 ± 0.14 cm2/m2, p < 0.0005, respectively). Hospital mortality was significantly higher (16.7% vs. 1.8%, p < 0.05) and 5-year overall survival was lower (58 ± 17 vs. 84 ± 4.2 months, p < 0.005) in the LF than NF group.

Conclusion

Patients with LF AS had worse operative and long-term outcomes than those with NF, even though they had preserved LV function.

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Funding

All authors have nothing to disclose with regard to commercial support and this research was not funded.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan

    Shinya Fukui, Yumi Kakizawa, Kazuma Handa, Tomohiko Sakamoto & Yukitoshi Shirakawa

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  1. Shinya Fukui
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  2. Yumi Kakizawa
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  3. Kazuma Handa
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  4. Tomohiko Sakamoto
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  5. Yukitoshi Shirakawa
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Correspondence to Shinya Fukui.

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Fukui, S., Kakizawa, Y., Handa, K. et al. Impact of stroke volume on severe aortic stenosis in patients with normal left ventricular function. Gen Thorac Cardiovasc Surg 68, 129–135 (2020). https://doi.org/10.1007/s11748-019-01173-9

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  • DOI: https://doi.org/10.1007/s11748-019-01173-9

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