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Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis

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Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis. / Bing, Rong; Gu, Haotian; Chin, Calvin; Fang, Lingyun; White, Audrey; Everett, Russell J.; Spath, Nicholas B.; Park, Eunsoo; Jenkins, William S.A.; Shah, Anoop S.V.; Mills, Nicholas L.; Flapan, Andrew D.; Chambers, John B.; Newby, David E.; Chowienczyk, Phil; Dweck, Marc R.

In: Heart, Vol. 106, No. 16, 2020-316684, 01.08.2020, p. 1236-1243.

Research output: Contribution to journalArticle

Harvard

Bing, R, Gu, H, Chin, C, Fang, L, White, A, Everett, RJ, Spath, NB, Park, E, Jenkins, WSA, Shah, ASV, Mills, NL, Flapan, AD, Chambers, JB, Newby, DE, Chowienczyk, P & Dweck, MR 2020, 'Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis', Heart, vol. 106, no. 16, 2020-316684, pp. 1236-1243. https://doi.org/10.1136/heartjnl-2020-316684

APA

Bing, R., Gu, H., Chin, C., Fang, L., White, A., Everett, R. J., Spath, N. B., Park, E., Jenkins, W. S. A., Shah, A. S. V., Mills, N. L., Flapan, A. D., Chambers, J. B., Newby, D. E., Chowienczyk, P., & Dweck, M. R. (2020). Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis. Heart, 106(16), 1236-1243. [2020-316684]. https://doi.org/10.1136/heartjnl-2020-316684

Vancouver

Bing R, Gu H, Chin C, Fang L, White A, Everett RJ et al. Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis. Heart. 2020 Aug 1;106(16):1236-1243. 2020-316684. https://doi.org/10.1136/heartjnl-2020-316684

Author

Bing, Rong ; Gu, Haotian ; Chin, Calvin ; Fang, Lingyun ; White, Audrey ; Everett, Russell J. ; Spath, Nicholas B. ; Park, Eunsoo ; Jenkins, William S.A. ; Shah, Anoop S.V. ; Mills, Nicholas L. ; Flapan, Andrew D. ; Chambers, John B. ; Newby, David E. ; Chowienczyk, Phil ; Dweck, Marc R. / Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis. In: Heart. 2020 ; Vol. 106, No. 16. pp. 1236-1243.

Bibtex Download

@article{b4b3dd95f8364843961e34db1f7e764d,
title = "Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis",
abstract = "Objective First-phase ejection fraction (EF1) is a novel measure of early left ventricular systolic dysfunction. We investigated determinants of EF1 and its prognostic value in aortic stenosis. Methods EF1 was measured retrospectively in participants of an echocardiography/cardiovascular magnetic resonance cohort study which recruited patients with aortic stenosis (peak aortic velocity of ≥2 m/s) between 2012 and 2014. Linear regression models were constructed to examine variables associated with EF1. Cox proportional hazards were used to determine the prognostic power of EF1 for aortic valve replacement (AVR, performed as part of clinical care in accordance with international guidelines) or death. Results Total follow-up of the 149 participants (69.8% male, 70 (65-76) years, mean gradient 33 (21-42) mm Hg) was 238 029 person-days. Sixty-seven participants (45%) had a low baseline EF1 (<25%) despite normal ejection fraction (67% (62%-71%)). Patients with low EF1 had more severe aortic stenosis (mean gradient 39 (34-45) mm Hg vs 24 (16-35) mm Hg, p<0.001) and more myocardial fibrosis (indexed extracellular volume (iECV) (24.2 (19.6-28.7) mL/m 2 vs 20.6 (16.8-24.3) mL/m 2, p=0.002; late gadolinium enhancement (LGE) prevalence 52% vs 20%, p<0.001). Zva, iECV and infarct LGE were independent predictors of EF1. EF1 improved post-AVR (n=57 with post-AVR EF1 available, baseline 16 (12-24) vs follow-up 27% (22%-31%); p<0.001). Low baseline EF1 was an independent predictor of AVR/death (HR 5.6, 95% CI 3.4 to 9.4), driven by AVR. Conclusion EF1 quantifies early, potentially reversible systolic dysfunction in aortic stenosis, is associated with global afterload and myocardial fibrosis, and is an independent predictor of AVR.",
keywords = "aortic stenosis, cardiac magnetic resonance (CMR) imaging, echocardiography, valve disease surgery",
author = "Rong Bing and Haotian Gu and Calvin Chin and Lingyun Fang and Audrey White and Everett, {Russell J.} and Spath, {Nicholas B.} and Eunsoo Park and Jenkins, {William S.A.} and Shah, {Anoop S.V.} and Mills, {Nicholas L.} and Flapan, {Andrew D.} and Chambers, {John B.} and Newby, {David E.} and Phil Chowienczyk and Dweck, {Marc R.}",
year = "2020",
month = aug,
day = "1",
doi = "10.1136/heartjnl-2020-316684",
language = "English",
volume = "106",
pages = "1236--1243",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group Ltd",
number = "16",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis

AU - Bing, Rong

AU - Gu, Haotian

AU - Chin, Calvin

AU - Fang, Lingyun

AU - White, Audrey

AU - Everett, Russell J.

AU - Spath, Nicholas B.

AU - Park, Eunsoo

AU - Jenkins, William S.A.

AU - Shah, Anoop S.V.

AU - Mills, Nicholas L.

AU - Flapan, Andrew D.

AU - Chambers, John B.

AU - Newby, David E.

AU - Chowienczyk, Phil

AU - Dweck, Marc R.

PY - 2020/8/1

Y1 - 2020/8/1

N2 - Objective First-phase ejection fraction (EF1) is a novel measure of early left ventricular systolic dysfunction. We investigated determinants of EF1 and its prognostic value in aortic stenosis. Methods EF1 was measured retrospectively in participants of an echocardiography/cardiovascular magnetic resonance cohort study which recruited patients with aortic stenosis (peak aortic velocity of ≥2 m/s) between 2012 and 2014. Linear regression models were constructed to examine variables associated with EF1. Cox proportional hazards were used to determine the prognostic power of EF1 for aortic valve replacement (AVR, performed as part of clinical care in accordance with international guidelines) or death. Results Total follow-up of the 149 participants (69.8% male, 70 (65-76) years, mean gradient 33 (21-42) mm Hg) was 238 029 person-days. Sixty-seven participants (45%) had a low baseline EF1 (<25%) despite normal ejection fraction (67% (62%-71%)). Patients with low EF1 had more severe aortic stenosis (mean gradient 39 (34-45) mm Hg vs 24 (16-35) mm Hg, p<0.001) and more myocardial fibrosis (indexed extracellular volume (iECV) (24.2 (19.6-28.7) mL/m 2 vs 20.6 (16.8-24.3) mL/m 2, p=0.002; late gadolinium enhancement (LGE) prevalence 52% vs 20%, p<0.001). Zva, iECV and infarct LGE were independent predictors of EF1. EF1 improved post-AVR (n=57 with post-AVR EF1 available, baseline 16 (12-24) vs follow-up 27% (22%-31%); p<0.001). Low baseline EF1 was an independent predictor of AVR/death (HR 5.6, 95% CI 3.4 to 9.4), driven by AVR. Conclusion EF1 quantifies early, potentially reversible systolic dysfunction in aortic stenosis, is associated with global afterload and myocardial fibrosis, and is an independent predictor of AVR.

AB - Objective First-phase ejection fraction (EF1) is a novel measure of early left ventricular systolic dysfunction. We investigated determinants of EF1 and its prognostic value in aortic stenosis. Methods EF1 was measured retrospectively in participants of an echocardiography/cardiovascular magnetic resonance cohort study which recruited patients with aortic stenosis (peak aortic velocity of ≥2 m/s) between 2012 and 2014. Linear regression models were constructed to examine variables associated with EF1. Cox proportional hazards were used to determine the prognostic power of EF1 for aortic valve replacement (AVR, performed as part of clinical care in accordance with international guidelines) or death. Results Total follow-up of the 149 participants (69.8% male, 70 (65-76) years, mean gradient 33 (21-42) mm Hg) was 238 029 person-days. Sixty-seven participants (45%) had a low baseline EF1 (<25%) despite normal ejection fraction (67% (62%-71%)). Patients with low EF1 had more severe aortic stenosis (mean gradient 39 (34-45) mm Hg vs 24 (16-35) mm Hg, p<0.001) and more myocardial fibrosis (indexed extracellular volume (iECV) (24.2 (19.6-28.7) mL/m 2 vs 20.6 (16.8-24.3) mL/m 2, p=0.002; late gadolinium enhancement (LGE) prevalence 52% vs 20%, p<0.001). Zva, iECV and infarct LGE were independent predictors of EF1. EF1 improved post-AVR (n=57 with post-AVR EF1 available, baseline 16 (12-24) vs follow-up 27% (22%-31%); p<0.001). Low baseline EF1 was an independent predictor of AVR/death (HR 5.6, 95% CI 3.4 to 9.4), driven by AVR. Conclusion EF1 quantifies early, potentially reversible systolic dysfunction in aortic stenosis, is associated with global afterload and myocardial fibrosis, and is an independent predictor of AVR.

KW - aortic stenosis

KW - cardiac magnetic resonance (CMR) imaging

KW - echocardiography

KW - valve disease surgery

UR - http://www.scopus.com/inward/record.url?scp=85084520069&partnerID=8YFLogxK

U2 - 10.1136/heartjnl-2020-316684

DO - 10.1136/heartjnl-2020-316684

M3 - Article

C2 - 32345658

AN - SCOPUS:85084520069

VL - 106

SP - 1236

EP - 1243

JO - Heart

JF - Heart

SN - 1355-6037

IS - 16

M1 - 2020-316684

ER -

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