Increased Left Ventricular Diastolic Stiffness Is Associated With Heart Failure Symptoms in Aortic Stenosis Patients With Preserved Ejection Fraction

Daisuke Kamimura, Takeki Suzuki, Ervin R. Fox, Thomas N. Skelton, Michael D. Winniford, Michael E. Hall

Research output: Contribution to journalArticle


Background Clinical risk factors associated with heart failure (HF) symptoms in aortic stenosis (AS) patients with preserved ejection fraction (EF) have not been fully identified. We hypothesized that left ventricular (LV) diastolic stiffness is associated with HF symptoms in patients with AS. Methods and Results We retrospectively evaluated 275 patients with at least moderate AS (aortic valve area <1.5 cm2) and preserved EF (≥50%). LV diastolic stiffness was evaluated with the use of echocardiographic parameters, diastolic wall strain (DWS, a measure of LV wall stiffness), and KLV (a marker of LV chamber stiffness). There were 69 patients with HF. Patients with HF were older, were more likely to be African American, had a higher body mass index, and had more hypertension and coronary artery disease (P <.05 for all). Aortic valve area index and mean pressure gradient across the aortic valve were not different between patients with and without HF. Despite similar echocardiographic parameters of AS severity, patients with HF had stiffer LV (DWS 0.21 ± 0.06 vs 0.25 ± 0.06 [P <.01], KLV 0.17 ± 0.11 vs 0.13 ± 0.08 [P <.01]). Logistic regression analyses revealed that after adjusting for age, race, body mass index, history of hypertension, and coronary artery disease, LV diastolic stiffness parameters remained significantly associated with HF symptoms. Conclusions LV diastolic stiffness is independently associated with HF in AS patients with preserved EF.

Original languageEnglish (US)
Pages (from-to)581-588
Number of pages8
JournalJournal of Cardiac Failure
Issue number8
StatePublished - Aug 2017



  • Aortic valve stenosis
  • diastolic stiffness
  • echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this