Prognostic value of energy loss index in patients with low gradient severe aortic stenosis and preserved ejection fraction

International audienceAbstract Background Assessment of pressure recovery adjusted indexed aortic valve area (AVAi) – energy loss index (ELI) – has been shown of prognostic interest for patients with asymptomatic and/or mild aortic stenosis (AS), but limited data are available in the setting of low gradient aortic stenosis (LG-AS). Purpose We hypothesized that among these patients with LG-AS, reclassification of AS severity as moderate by ELI may help to identify a subgroup of patients with moderate AS. Methods 379 patients with low gradient severe AS (defined by AVAi ≤0.6 cm2/m2 and mean aortic pressure gradient (MPG) 0.6 cm2/m2. Clinical and echocardiographic features of patients reclassified by ELI were studied. Clinical outcomes were all-cause and cardiac mortality. Results 148 patients (39%) were reclassified as moderate AS by ELI. By multivariable logistic regression analysis, patients being reclassified as moderate AS by ELI were associated with increased stroke volume index (SVi), absence of documented coronary artery disease and decreased body surface area, left indexed ventricular mass (all p