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

Badiani, S; van Zalen, J; Treibel, TA; Bhattacharyya, S; Moon, JC; Lloyd, G; (2016) Aortic Stenosis, a Left Ventricular Disease: Insights from Advanced Imaging. Current Cardiology Reports , 18 (8) , Article 80. 10.1007/s11886-016-0753-6. Green open access

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Abstract

Aortic stenosis (AS) is the most common primary valve disorder in the elderly with an increasing prevalence. It is increasingly clear that it is also a disease of the left ventricle (LV) rather than purely the aortic valve. The transition from left ventricular hypertrophy to fibrosis results in the eventual adverse effects on systolic and diastolic function. Appropriate selection of patients for aortic valve intervention is crucial, and current guidelines recommend aortic valve replacement in severe AS with symptoms or in asymptomatic patients with left ventricular ejection fraction (LVEF) <50 %. LVEF is not a sensitive marker and there are other parameters used in multimodality imaging techniques, including longitudinal strain, exercise stress echo and cardiac MRI that may assist in detecting subclinical and subtle LV dysfunction. These findings offer potentially better ways to evaluate patients, time surgery, predict recovery and potentially offer targets for specific therapies. This article outlines the pathophysiology behind the LV response to aortic stenosis and the role of advanced multimodality imaging in describing it.

Type: Article
Title: Aortic Stenosis, a Left Ventricular Disease: Insights from Advanced Imaging
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s11886-016-0753-6
Publisher version: http://doi.org/10.1007/s11886-016-0753-6
Language: English
Additional information: © The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Aortic stenosis, Cardiac magnetic resonance, Echocardiography, Left ventricle, Myocardial fibrosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/1504010
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