The results presented in this study (2) further confirm that the geometry of the ventricle is a strong determinant of myocardial systolic function and LV concentric hypertrophy is associated with a worst degree of myocardial impairment. Hence, the assessment of LV geometry and function in patients with AS should be more comprehensive and go beyond the sole measurement of LV mass and ejection fraction. This evaluation should also include the relative wall thickness to assess the degree of concentric remodelling and the longitudinal myocardial strain to properly identify and quantify myocardial systolic dysfunction. Given that these indices can now be measured routinely and reproducibly, we thus believe that they should be incorporated in the routine echocardiographic follow-up of patients with AS.
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