Ventricular pressure-volume loop and other heart function metrics can elucidate etiology of failure of TAVI and interventions

Abstract

Aortic valve stenosis is one of the most acute and chronic cardiovascular disease conditions. Bicuspid aortic valve is the most common congenital heart abnormality and affected individuals have a 50% chance of developing severe aortic valve stenosis during their lifetime. In aortic valve disease (both aortic valve stenosis and bicuspid aortic valve), the heart valves are damaged and do not work properly. This condition can rapidly affect the pumping action of the heart and can progress to heart failure. Heart failure is a deadly disease affecting at least 26 million people worldwide and its prevalence is increasing with high mortality and morbidity.1 Most importantly, aortic valve disease commonly coexists with other cardiovascular diseases, giving rise to the most general yet fundamentally challenging scenario: complex valvular, ventricular, and vascular diseases (C3VD). In C3VD, multiple valvular, ventricular, and vascular pathologies interact with one another, while the physical phenomena associated with each pathology amplify the effects of others on the cardiovascular system. Left ventricle (LV) pressure-volume (P-V) loop analysis is a powerful tool to assess cardiac mechanics. This analysis can reveal the pathophysiological mechanisms of heart failure, including heart failure with preserved ejection fraction and myocardial and valvular diseases. It is, therefore, instrumental in...