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).