PMID- 29676482 OWN - NLM STAT- MEDLINE DCOM- 20181211 LR - 20181211 IS - 1540-8175 (Electronic) IS - 0742-2822 (Linking) VI - 35 IP - 8 DP - 2018 Aug TI - Severe heart failure (NYHA Class IV) is associated with increased left ventricular mass index and short mitral deceleration time in severe aortic valve stenosis. PG - 1108-1115 LID - 10.1111/echo.13895 [doi] AB - BACKGROUND: In aortic valve stenosis (AS), congestive heart failure (CHF) is a well-established symptom that indicates the need for surgical aortic valve replacement (SAVR). However, it is difficult to judge whether CHF symptoms such as dyspnea are caused by severe AS or other conditions, especially in elderly persons with restricted mobility or other organ complications. It is important to identify objective and noninvasive parameters associated with severe CHF symptoms in severe AS. METHODS: One hundred ninety-eight patients with severe AS without left ventricular (LV) dysfunction were retrospectively studied. CHF symptoms were classified by New York Heart Association (NYHA) functional class. Echo parameters were compared between NYHA I-III and NYHA IV. RESULTS: Patients with NYHA IV (n = 40; 20%) were older (86 +/- 6 vs 82 +/- 8 years; P = .001) and had a larger LV mass index (LVMI) (157 +/- 43 vs 114 +/- 34 g/m(2) , P < .001), a higher transmitral flow velocity ratio (E/A) (1.31 +/- 0.62 vs 0.93 +/- 0.42; P = .001), a shorter deceleration time (DT) (202 +/- 72 vs 286 +/- 98 ms; P < .001), and a higher systolic pulmonary arterial pressure (SPAP) (44 +/- 13 vs 35 +/- 13 mm Hg; P < .001) than patients with NYHA I-III. On multivariable analysis, LVMI and DT were independently associated with NYHA IV. Receiver operating characteristic curve analysis identified LVMI >/= 142 g/m(2) and DT