Model-based aortic power transfer: A potential measure for quantifying aortic stenosis severity based on measured data

Current aortic stenosis severity grading is based mainly on the local properties of the stenotic valve, such as pressure gradient or jet velocity. Success rates of valve replacement therapy are still suboptimal, so alternative grading of AS should be investigated. We suggest the efficiency of power transfer from the left ventricle to the aorta, as it takes into account heart, valve and circulatory system. Left ventricular and circulatory power were estimated using a 0D model, which was optimised to patient data: left ventricular and aortic pressure, aortic flow and diastolic left ventricular volume. Optimisation was performed using a data assimilation method. These data were available in rest as well as chemically induced exercise for twelve patients. Using this limited data set, we showed that aortic valve efficiency is highly heterogeneous between patients, but also often dependent on the haemodynamic load. This indicates that power transfer efficiency is a highly interesting metric for further research in aortic stenosis. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of IPEM.

Automated summary

Current grading of aortic stenosis severity focuses on local valve properties like pressure gradient or jet velocity, but alternative methods are needed due to suboptimal success rates of valve replacement therapy. This study suggests evaluating power transfer efficiency from the left ventricle to the aorta, which considers heart, valve, and circulatory system. The research demonstrates heterogeneous aortic valve efficiency among patients and highlights the importance of further investigation into power transfer efficiency in aortic stenosis.