Predictive value of left ventricular global function index in patients with aortic stenosis

Abstract

A number of factors has an impact on the survival prognosis in aortic stenosis patients. One of these factors is a left ventricular (LV) systolic function. Left ventricular global function index (LVGFI) takes into account the components of LV remodeling: LV volume, LV stroke volume, and LV myocardial volume.Objective: to evaluate the prognostic value of LVGFI in patients with various aortic stenosis severity using echocardiography.Material and methods. The study based on the data of previous prospective observational study from 2010–2016, followed by retrospective calculation and analysis of the LVGFI obtained by echocardiography. A total of 377 patients were included to the study, the average age was 79 (75–84) years; 128 (34%) of them were male; 70 patients (19%) had mild aortic stenosis, 116 patients (31%) moderate aortic stenosis, and 191 patients (50%) severe aortic stenosis. LVGFI was calculated as the percentage ratio of LV stroke volume to LV global volume, where LV global volume was defined as the sum of the LV mean cavity volume [(LV end-diastolic volume + LV end-systolic volume)/2] and the myocardium volume. LV myocardial volume was calculated as the ratio of LV myocardial mass to LV density (defined as 1.05 g/mL). The average follow-up period at the moment of analysis was 602.7 ± 48.72 days. All cases of death during the period of follow up were captured.Results. The significant differences of LVGFI obtained between surviving and deceased patients (15.39% (11.35–20.95%) and 20.12% (15.16–25.98%), respectively, p < 0.001). Values of LVGFI < 18% significantly associated with the risk of death from all causes during two years of follow-up in both mild aortic stenosis and moderate and severe aortic stenosis.Conclusion. Thus, in patients with aortic stenosis in the group of fatal outcomes the values of the LVGFI were significantly lower than in the group of surviving patients. LVGFI values of less than 18% associated with the risk of death from all causes in any grade of aortic stenosis. LVGFI can be used for mortality risk stratification in patients with aortic stenosis.