BACKGROUND: In @entity472 ( @entity472 ), symptoms and @entity1002 represent a later disease state, and objective parameters that identify incipient @entity1002 are needed. We sought to determine prognostic utility of @entity3876 ( @entity3876 ) and @entity1002 ( @entity1002 ) in @entity1 with aortic valve area <1.3 cm(2). METHODS AND RESULTS: Five-hundred and thirty-one @entity1 between January 2007 and December 2008 with aortic valve area <1.3 cm(2) (86% with aortic valve area  <=1.1 cm(2)) and left ventricular ejection fraction >= 50% who had @entity3876 drawn  <=90 days from initial echo were included. Society of Thoracic Surgeons (STS) score and mortality were recorded. Mean STS score, glomerular filtration rate, and median @entity3876 were 11  5, 73  35 mL/min per 1.73 m , and 141 (60-313) pg/mL, respectively; 78% were in New York Heart Association class >= II. Mean LV- @entity64 volume index (LV-SVI) and @entity1002 were 39  10 mL/m(2) and -13.9  3%. At 4.7  2 years, 405 @entity1 (76%) underwent aortic valve replacement; 161 died (30%). On multivariable survival analysis, age (hazard ratio [HR] 1.46), New York Heart Association class (HR 1.27), coronary artery disease (HR 1.72), decreasing glomerular filtration rate (HR 1.15), increasing @entity3876 (HR 1.16), worsening @entity1002 (time dependent) (HR 0.34) predicted survival (all P<0.01). For mortality, the c-statistic incrementally increased as follows (all P<0.01): STS score (0.60 [0.58-0.64]), STS score+ @entity3876 (0.67 [0.62-0.70]), and STS score+ @entity3876 + @entity1002 (0.74 [0.68-0.78]). CONCLUSIONS: In normal LVEF @entity1 with significant @entity472 , @entity3876 and @entity1002 provide incremental (additive not duplicative) prognostic information over established predictors, suggesting that both play a synergistic role in defining outcomes.

Synergistic Utility of @entity3876 and Left Ventricular Strain in XXXX With Significant @entity472 .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity3876 :: ('4879', 'Gene') :: ['brain natriuretic peptide', 'BNP'] @entity472 :: ('MESH:D001024', 'Disease') :: ['AS', 'aortic stenosis'] @entity1002 :: ('MESH:D018487', 'Disease') :: ['left ventricular global longitudinal strain', 'LV-GLS', 'left ventricular (LV) dysfunction', 'LV dysfunction', 'LV-GLS (HR 1.13) and aortic valve replacement']
@entity1 :: (9606,Species) :: ['Patients']
