Aortic stenosis and right ventricular dysfunction.

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Physiology

Background:

• Right ventricular function is often overlooked in aortic stenosis management.
• Severe aortic stenosis impacts both left and right ventricular function.

Purpose of the Study:

• To assess the significance of right ventricular dysfunction in severe aortic stenosis using 3D echocardiography.
• To compare right ventricular function between high-gradient and low-gradient aortic stenosis.

Main Methods:

• Prospective analysis of 68 patients with severe high and low-gradient aortic stenosis.
• Utilized 3D echocardiography for comprehensive ventricular function assessment.
• Evaluated end-diastolic, end-systolic volumes, ejection fraction, and stroke volumes.

Main Results:

• Right ventricular dysfunction (RVEF < 45%) was more frequent in the low-gradient group (63.6%) vs. high-gradient group (39%).
• Low-gradient patients exhibited poorer right ventricular function (RVEF 36% vs. 46%).
• Left ventricular ejection fraction strongly correlated with right ventricular ejection fraction (r=0.78, p<0.0001); LV function predicted RV function.

Conclusions:

• Right ventricular dysfunction is more common in low-gradient severe aortic stenosis.
• Left ventricular dysfunction is the primary predictor of right ventricular dysfunction in this cohort.
• Pulmonary hypertension does not predict right ventricular dysfunction in severe aortic stenosis.