Degree of left ventricular dilatation at end‐diastole: Correlation and prognostic utility of quantitative volumes by 2D‐echocardiography versus linear dimensions in patients with asymptomatic aortic regurgitation

• Published in: Echocardiography (Mount Kisco, N.Y.) N.Y.), 2020-09, Vol.37 (9), p.1336-1344
• Main Authors: Barbieri, Andrea, Benfari, Giovanni, Giubertoni, Elisa, Manicardi, Marcella, Bursi, Francesca, Rossi, Andrea, Maritan, Luca, Venturi, Gabriele, Boriani, Giuseppe
• Format: Article
• Language: English
• Subjects: aortic regurgitation; aortic valve disease; cardiovascular outcome; left ventricular remodeling
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.14815

Background Guideline recommendations for aortic valve replacement (AVR) in asymptomatic patients with chronic aortic regurgitation (AR) have historically focused on linear dimensions without normalization for the body surface area (BSA). Values for grading the severity of end‐diastolic volume dilatation by 2D echocardiography remain to be established. Methods and Results We retrospectively analyzed 543 consecutive asymptomatic patients with pure chronic moderate/severe AR (mean age 66 ± 17 years, 37.7% males). Applying the ASE/EACVI guidelines, BSA‐indexed LV end‐diastolic volume (LVEDVi) and indexed LV end‐diastolic diameter (LVEDDi) were assessed. Then, we identified 192 patients with at least mild LV end‐diastolic dilatation by volumetric or linear measurements. The outcome endpoint was the combination of cardiac death, hospitalization for acute heart failure or AVR during a median follow‐up of 4.5 ± 3.6 years. Multivariable Cox regression analyses including age, LV ejection fraction (EF) and AR severity showed an independent prognostic value of the LVEDDi and LVEDVi (P