Objective Mild aortic valve stenosis (AS) and aortic valve (AV) sclerosis are associated with diastolic dysfunction and increased mortality in the general population. This study specifically investigated the impact of mild AV disease in heart failure with preserved ejection fraction (HFpEF). Methods Consecutive patients hospitalised with HFpEF (n=370) underwent assessment of cardiac structure and function and long-term clinical follow-up. Results In the study cohort, 111 had mild AS (30%), 104 AV sclerosis (28%) and 155 a non-calcified AV (42%). Mild-to-moderate AV regurgitation (AR) was present in 64 (17%). Compared with patients with a normal AV, those with AV disease were older, with worse renal function and more atrial fibrillation. E/e′ increased from non-calcified AV to AV sclerosis to mild AS (13.8 (10.8–16.8) vs 15.0 (10.9–20.0) vs 18.0 (12.7–23.3), respectively; p<0.001)). Left ventricular diastolic pressure–volume relationships were shifted leftwards in patients with AS and AV sclerosis, but not influenced by AR. The left ventricular end-diastolic volume normalised at 20 mm Hg was 117±34 mL, 106±30 mL and 112±30 mL in non-calcified AV, AV sclerosis and mild AS, respectively (p=0.023), while 112±32 mL in mild-to-moderate AR. Over 30 months (IQR, 8–61 months), 247 patients died (67%). The presence of mild AV disease was associated with increased mortality, but this was no longer significant after adjusting for age and sex. Conclusions Low-grade AV disease is common among patients hospitalised for HFpEF and is associated with older age, atrial arrhythmia, renal dysfunction, higher left heart filling pressures and increased left ventricular chamber stiffness. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. The data underlying this article will be shared on reasonable request to the corresponding author.

中文翻译：

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射血分数保留心力衰竭中轻度主动脉瓣疾病和舒张压-容积关系

目的 轻度主动脉瓣狭窄 (AS) 和主动脉瓣 (AV) 硬化与一般人群的舒张功能障碍和死亡率增加有关。本研究专门调查了轻度 AV 疾病对射血分数保留的心力衰竭 (HFpEF) 的影响。方法 HFpEF 连续住院患者（n=370）接受心脏结构和功能评估和长期临床随访。结果 在研究队列中，111 名患有轻度 AS（30%），104 名 AV 硬化（28%）和 155 名非钙化 AV（42%）。64 例 (17%) 存在轻度至中度 AV 反流 (AR)。与房室正常的患者相比，房室疾病患者年龄更大，肾功能更差，房颤发生率更高。E/e' 从非钙化 AV 增加到 AV 硬化到轻度 AS (13.8 (10.8-16.8) vs 15.0 (10.9-20.0) vs 18。0 (12.7–23.3), 分别; p<0.001))。AS 和 AV 硬化患者的左心室舒张压-容积关系向左移动，但不受 AR 影响。在非钙化 AV、AV 硬化和轻度 AS 中，在 20 mm Hg 时标准化的左心室舒张末期容积分别为 117±34 mL、106±30 mL 和 112±30 mL（p=0.023），而 112±32 mL 在轻度至中度 AR 中。超过 30 个月（IQR，8-61 个月），247 名患者死亡（67%）。轻度 AV 疾病的存在与死亡率增加有关，但在调整年龄和性别后，这不再显着。结论 低级别 AV 疾病在因 HFpEF 住院的患者中很常见，并且与年龄较大、房性心律失常、肾功能不全、左心充盈压升高和左心室硬度增加有关。可根据合理要求提供数据。所有与研究相关的数据都包含在文章中或作为补充信息上传。本文所依据的数据将根据合理要求分享给通讯作者。