Aortic stenosis and myocardial work
It is known that severe aortic stenosis may lead to premature end of
life, if untreated, as shown by the scholarly paper by Ross and
Braunwald 54 years ago 9. However, the question
regarding timing of valve replacement is not a straightforward one for
several reasons mainly subjective development of symptoms and objective
evidence so called “collateral damage” (extra valvular damage due to
sustained afterload increase). Serial follow up is therefore necessary
to evaluate the progression of the disease. The 2020 ACC recommendations10 has outlined a follow up interval for example in
case of moderate disease. Keeping in mind that, it is also possible by
analyzing myocardial work indices including global wasted work and
global work efficiency to accurately predict valve area compared to
traditional methods like the continuity equation, aiding in optimal
decision-making for follow up prior to valve replacement (Figures, 2,
3).