Diastolic dysfunction in severe aortic stenosis: Old but still gold

Area of Science:

• Cardiology
• Medical Imaging
• Clinical Decision Making

Background:

• Symptomatic severe aortic stenosis (sAS) patients undergoing transcatheter aortic valve implantation (TAVI) require improved risk stratification.
• Left ventricular diastolic dysfunction (DD), assessed by E/A ratio, is a potential factor in sAS patient outcomes.

Discussion:

• Severe DD identified by E/A ratio in sAS patients undergoing TAVI is associated with increased post-procedural mortality or heart failure hospitalization.
• However, baseline severe DD is not an independent predictor of outcomes in this population.

Key Insights:

• A simple, reproducible risk predictor is needed for sAS patients undergoing TAVI.
• Diastolic dysfunction parameters require further investigation and validation.

Outlook:

• Large-scale studies using multimodality imaging are necessary to validate DD parameters.
• Future research should account for sex and comorbidities to refine risk prediction models for TAVI patients.