Impact of left atrial and diastolic ventricular dysfunction on mortality in patients with aortic stenosis

Thellier, Nicolas; Altes, Alexandre; Layec, Jeremy; Castel, Anne Laure; Delelis, François; Hubert, Tiffany; Outerryck, François; Appert, Ludovic; Tribouilloy, Christophe; Maréchaux, Sylvestre

doi:10.1016/j.acvd.2022.12.006

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…measured LA and ventricular diastolic dysfunction in 387 patients with severe AS. Patients with diastolic dysfunction and PALS <14% were found to have increased mortality 30 . Springhetti et al.…”

Section: Resultsmentioning

confidence: 98%

“…The included studies reported PALS in patients with AS as summarized in 2. 15,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] LA strain was significantly reduced in AS patients and a PALS <21% was an independent predictor of prognosis. 21 strain (PALS) was independently associated with the primary outcome and an optimal cut-off value of <19% showed the highest diagnostic performance.…”

Section: Pals In Patients With Asmentioning

confidence: 99%

“…Patients with diastolic dysfunction and PALS <14% were found to have increased mortality. 30 Springhetti et al analyzed the association of PALS with outcomes in 467 patients with moderate and severe AS. PALS was independently associated with the primary outcome and an optimal cut-off value of <16% was associated with an increased risk of events.…”

Section: Pals In Patients With Asmentioning

confidence: 99%

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Prognostic value of left atrial strain in aortic stenosis: A systematic review

Lacy,

Thomas,

Syed

et al. 2024

Echocardiography

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PurposeAortic stenosis (AS) is a common valvular heart disease with high morbidity and mortality. Recently, the association between peak atrial longitudinal strain (PALS) and AS clinical outcomes has been identified. This systematic review evaluates the prognostic value of PALS for adverse events in AS.MethodsWe performed a systematic literature review to identify clinical studies that evaluated Speckle–Tracking Echocardiography (STE)‐derived PALS to predict adverse outcomes in patients with AS. We excluded studies that compared echocardiography to computed tomography and studies that focused on diseases other than AS.ResultsWe included 18 studies reporting on 2660 patients. Patients with symptomatic AS had decreased PALS when compared to patients with asymptomatic AS. Patients with AS who had adverse events had decreased PALS when compared to patients with AS with no events. Each unit increase of PALS was independently associated with decreased risk for the primary endpoint. PALS cut‐off values were associated with increased risk for the primary endpoint.ConclusionThis systematic review suggests PALS as an independent predictor for cardiovascular events in patients with AS and highlights the importance of evaluating LA mechanics for AS prognosis.

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Section: Resultsmentioning

confidence: 98%

Section: Pals In Patients With Asmentioning

confidence: 99%

Section: Pals In Patients With Asmentioning

confidence: 99%

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Prognostic value of left atrial strain in aortic stenosis: A systematic review

Lacy,

Thomas,

Syed

et al. 2024

Echocardiography

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Additive Prognostic Value of Left Ventricular Dispersion and Deformation in Patients With Severe Aortic Stenosis

Thellier,

Altes,

Rietz

et al. 2024

JACC: Cardiovascular Imaging

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Concomitant cardiac amyloidosis and aortic stenosis: update on diagnosis and management

Omer,

Shafqat,

Zenses

et al. 2024

Journal of the Heart Valve Society

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Concomitant aortic stenosis (AS) and cardiac amyloidosis (CA) represent a significant and increasingly recognized clinical challenge, particularly in elderly populations. This review aims to present current knowledge on the prevalence, clinical characteristics, imaging findings, outcomes and management strategies for patients with both AS and CA. Studies indicate that transthyretin cardiac amyloidosis (ATTR-CA) frequently coexists with AS, especially in patients undergoing transcatheter aortic valve replacement (TAVR), with prevalence rates ranging from 4% to 16%. The dual pathology exacerbates heart failure risk, increases mortality, and complicates therapeutic decision-making. Diagnosing CA in the presence of AS is complex due to overlapping clinical and imaging features. A multi-parametric diagnostic approach is essential, incorporating clinical assessment, advanced echocardiography, cardiac magnetic resonance imaging, and bone scintigraphy of the heart. The presence of CA influences the management of AS, often favoring TAVR over surgical valve replacement due to increased surgical risk. Emerging pharmacological treatments for ATTR-CA offer survival benefits and may alter the natural disease progression. This review highlights the need for heightened clinical awareness, early diagnosis through advanced imaging modalities, and tailored therapeutic strategies to improve outcomes in patients with concomitant AS and CA.

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Impact of left atrial and diastolic ventricular dysfunction on mortality in patients with aortic stenosis

Cited by 4 publications

References 26 publications

Prognostic value of left atrial strain in aortic stenosis: A systematic review

Prognostic value of left atrial strain in aortic stenosis: A systematic review

Additive Prognostic Value of Left Ventricular Dispersion and Deformation in Patients With Severe Aortic Stenosis

Concomitant cardiac amyloidosis and aortic stenosis: update on diagnosis and management

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