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In AS (n\u2009=\u200959), AS\/AR (n\u2009=\u200921) and controls (n\u2009=\u200914), surrogates for LV myocardial power and circulatory\/external myocardial efficiency were obtained from cardiac MRI. Median surrogate LV myocardial power was increased in AS, 7.7\u2009W\/m<jats:sup>2<\/jats:sup> (interquartile range 6.0\u201310.2; p\u2009=\u20090.010) and AS\/AR, 10.8\u2009W\/m<jats:sup>2<\/jats:sup> (8.9\u201313.4; p\u2009&lt;\u20090.001) when compared to controls, 5.4\u2009W\/m<jats:sup>2<\/jats:sup> (4.2\u20136.5), and was lower in AS than AS\/AR (p\u2009&lt;\u20090.001). Surrogate circulatory efficiency was decreased in AS, 8.6% (6.8\u201311.1; p\u2009&lt;\u20090.001) and AS\/AR, 5.4% (4.1\u20136.2; p\u2009&lt;\u20090.001) when compared to controls, 11.8% (9.8\u201316.9). Surrogate external myocardial efficiency was higher in AS, 15.2% (11.9\u201318.6) than in AS\/AR, 12.2% (10.1\u201314.2; p\u2009=\u20090.031) and was significantly lower compared to controls, 12.2% (10.7\u201318.1) in patients with reduced ejection fraction (EF), 9.8% (8.1\u201311.7; p\u2009=\u20090.025). In 16% of all cases, left ventricular mass\/volume indices and EF were within normal ranges, wheras surrogate LV myocardial power was elevated and patients were symptomatic. Although influenced by pressure\/volume load, the myocardium is additionally affected by remodelling processes. Surrogates for circulatory efficiency and LV myocardial power gradually reflect alterations in patients with AS and AS\/AR, even when surrogate external myocardial efficiency, EF, mass and volume indices still remain compensated.<\/jats:p>","DOI":"10.1038\/s41598-019-52909-9","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T11:03:02Z","timestamp":1573470182000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Surrogates for myocardial power and power efficiency in patients with aortic valve disease"],"prefix":"10.1038","volume":"9","author":[{"given":"Chong-Bin","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonid","family":"Goubergrits","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joao Filipe","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Nordmeyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Knosalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Berger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-8620","authenticated-orcid":false,"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Titus","family":"Kuehne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4971-0452","authenticated-orcid":false,"given":"Marcus","family":"Kelm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"52909_CR1","doi-asserted-by":"publisher","first-page":"1790","DOI":"10.1093\/eurheartj\/ehi290","volume":"26","author":"M Kupari","year":"2005","unstructured":"Kupari, M., Turto, H. & Lommi, J. 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