Aortic Stenosis, a Left Ventricular Disease: Insights from Advanced Imaging

Area of Science:

• Cardiology
• Cardiovascular Imaging

Background:

• Aortic stenosis (AS) is the most common heart valve disorder in older adults.
• AS is increasingly recognized as a disease affecting the left ventricle (LV), leading to hypertrophy and fibrosis.
• This progression impairs both systolic and diastolic function.

Purpose of the Study:

• To outline the pathophysiology of the LV response to AS.
• To highlight the role of advanced multimodality imaging in evaluating LV dysfunction in AS patients.
• To explore how imaging can improve patient selection, surgical timing, and therapy targets.

Main Methods:

• Review of current understanding of AS pathophysiology.
• Discussion of multimodality imaging techniques (e.g., strain, stress echo, cardiac MRI).
• Analysis of parameters beyond left ventricular ejection fraction (LVEF).

Main Results:

• LVEF is an insensitive marker for LV dysfunction in AS.
• Advanced imaging parameters like longitudinal strain can detect subclinical LV dysfunction.
• Multimodality imaging offers better tools for patient assessment and surgical decision-making.

Conclusions:

• The LV plays a critical role in the progression and manifestation of AS.
• Advanced imaging techniques are essential for comprehensive evaluation of AS patients.
• Improved assessment through imaging can lead to better patient outcomes and targeted therapies.