Prognostic value of exercise left ventricular end-systolic volume index in patients with asymptomatic aortic regurgitation: an exercise echocardiography study

Abstract

Exercise LVESVi might be an independent predictor of prognosis in patients with asymptomatic moderate or severe AR.

Ratiology and a Complementary Class of Metrics for Cardiovascular Investigations

“…Therefore, it comes not as a total surprise that a ratio such as EF may look meaningful for what turns out to be a secondary reason. In the case of EF, it has been established that ESV presents with demonstrated clinical usefulness (7,21,55,56,61,69), besides evidence based on physiology (38). As proposed in the past, EF may derive (FIGURE 6) its clinical utility from the importance of ESV (29, 38).…”

“…Clinically used metrics often serve as disease-or patient-oriented (bio)markers (6), meaning that they have been demonstrated to reliably predict an outcome. For example, end-systolic volume (ESV) index as determined during reperfusion therapy for acute myocardial infarction is a strong predictor of early and late mortality (56), an indicator for long-term survival after coronary artery bypass graft surgery (21), a sensitive marker of acute response to cardiac resynchronization therapy (7), the major determinant of survival after recovery from myocardial infarction (69), carries prognostic value in patients with asymptomatic aortic regurgitation when assessed during exercise (61) and serves as a predictor of heart failure hospitalization in stable coronary artery disease (55).…”

Stress echocardiography in valvular heart disease

“…Regarding AR, exercise testing may be useful for confirming diagnosis in severe AR patients with equivocal symptoms. Some echocardiographic parameters including LV contractile reserve (51), TAPSE (52), LV end-systolic volume index (53), and LV GLS (54) on exertion have been reported as prognostic parameters of AR. However, these findings were based on singlecenter observational studies and therefore, none of these parameters were included in current guidelines.…”