424 Underestimation of Left Ventricular (LV) Dilatation by Linear Dimensions in Comparison to Volumetric Assessment in Chronic Severe Aortic Regurgitation (AR) – Time to Update the Management Guidelines?

Chronic severe AR (CSAR) results in compensatory LV dilatation to maintain forward stroke volume. “Severe” dilatation (LV end-diastolic dimension (LVEDD)) ≥80mm is associated with sudden cardiac death and poorer postoperative outcomes. European Society of Cardiology guidelines recommend valve surgery (Class IIa) in asymptomatic patients with LVEDD>70mm and LV ejection fraction (LVEF)>50%. LVEDD underestimates LV dilatation due to geometrical limitations in comparison to volumetric measurements (Indexed LV end-diastolic volume (iLVEDV)), however thresholds for intervention remain unchanged.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Source Type: research