BACKGROUND: @entity1 with severe @entity472 ( @entity472 ) are known to have increased left ventricular apical rotation  (ApRot) during systole, but its clinical relevance is unknown. The aim of this study was to assess the association of ApRot with @entity1 symptoms and total mortality. METHODS: A retrospective analysis was performed on 82 @entity1 (mean age, 77      14  years; 40% @entity1 ) with newly diagnosed severe @entity472 with indexed aortic valve areas   <=  0.6  cm(2)/m(2) and left ventricular ejection fractions  >=   50%. Sixty-three percent of @entity1 were symptomatic. ApRot was calculated using speckle-tracking echocardiography. @entity1 were divided into two groups on the basis of ApRot: high ApRot (>4.0  , n  =  41) and low ApRot ( <=4.0  , n  =  41). RESULTS: There were 33 deaths and 30 aortic valve replacement procedures after 33      17  months of follow-up. @entity1 in the high-ApRot group had smaller indexed aortic valve areas (P  =  .021) and increased valvuloarterial impedance (P  =  .014). There was no difference in overall symptoms, but the low-ApRot group experienced more @entity1163 (P  =  .020). @entity1 in the high-ApRot group had reduced survival with medical therapy (log-rank P  =  .018) after aortic valve replacement (log-rank P  =  .039) and overall (log-rank P  =  .009). Asymptomatic @entity1  with low ApRot had the best survival, while asymptomatic @entity1 with high ApRot had similar survival  to that of symptomatic @entity1 (log-rank P  =  .008). On adjusted @entity797 regression, ApRot  >=   6.0   was independently associated with @entity204 (hazard ratio, 3.06; P  =  .003). On receiver operating characteristic curve analysis, ApRot added incremental prognostic value to indexed aortic valve area, symptom status, and aortic valve replacement status. CONCLUSION: Increased ApRot is independently associated with poor survival and may represent a compensatory mechanism to preserve cardiac output against severe obstruction to flow and high systolic load.

Increased Apical Rotation in Severe XXXX is Associated with Reduced Survival: A Speckle-Tracking Study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'men'] @entity797 :: ('1351', 'Gene') :: ['Cox'] @entity1163 :: ('MESH:D013575', 'Disease') :: ['syncope'] @entity472 :: ('MESH:D001024', 'Disease') :: ['AS', 'aortic stenosis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity472 :: (MESH:D001024,Disease) :: ['Aortic Stenosis']
