Noninvasive left ventricular stiffness in asymptomatic severe aortic stenosis: evidence for prognostic yield both at rest and during supine ergometry

Abstract Introduction Left ventricular (LV) stiffness can be estimated noninvasively with echocardiography, but has not been systematically evaluated in aortic stenosis (AS). Purpose Purpose was to assess noninvasively the LV stiffness in asymptomatic severe AS, both at rest (R) and during supine ergometry (Ex), and to interrogate potential relationships with the cardiac outcome. Methods Forty eight AS patients (pts), followed up on valve clinic in a tertiary center (age 66±12), were referred for Ex. Severe AS was defined as aortic valve area 35mL/min/m2) low gradient (NFLG,n=8) compared to low flow low gradient pts (LFLG, n=18) and normal flow/ high gradient (NFHG, n=22): R NFLG: 0.16±0.11 vs LFLG: 0.28±0.14 (p=0.014) and NFHG: 0.21/0.1 (p=0.04), Ex NFLG: 0.10±0.04 vs LFLG: 0.18±0.06 (p=0.04) and NFHG 0.22±0.12 (p=0.05) respectively. SVi was inversely related to LV stiffness at R/Ex (R2=0.23 /0.43, p