Development of paradoxical low-flow, low-gradient severe aortic stenosis

Heart
Jordi S DahlPatricia A Pellikka

Abstract

Among patients with severe aortic stenosis (sAS) and preserved LVEF, those with low-flow, low-gradient sAS (LFLG-sAS) have an adverse prognosis. It has been proposed that LFLG-sAS represents an end-stage point of sAS, but longitudinal information has not been described. The aim was to determine whether LFLG-sAS represents an end-stage consequence of normal-flow, high-gradient sAS (NFHG-sAS) or a different entity. From our transthoracic echocardiogram (TTE) database, we identified patients with sAS (aortic valve area <1 cm(2)) and preserved LVEF (≥50%), and from these, patients with LFLG-sAS (stroke volume index <35 mL/m(2) and mean transvalvular gradient <40 mm Hg) who had ≥1 additional TTE within five years prior to the index TTE. Patients were age/sex/date matched 2:1 with patients with NFHG-sAS and normal-flow, low-gradient (NFLG)-sAS who also had ≥1 TTE. Included were 1203 TTEs (383 index studies and 820 preceding studies). In 78 patients with LFLG-sAS, an HG stage preceded the index TTE in only 4 (5%). During the five years preceding the index TTE, patients with LFLG-sAS developed increasing relative wall thickness (0.42 to 0.49; p<0.001) without change in LV mass index. Patients with NFHG-sAS had a marked increase in LV m...Continue Reading

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Citations

Feb 20, 2016·Journal of Cardiovascular Translational Research·Ares Pasipoularides
Jan 12, 2016·Revista Española De Cardiología·Teresa López-FernándezJoaquín Barba-Cosials
Jan 30, 2016·Heart·Sorin V Pislaru, Patricia A Pellikka
Jul 19, 2016·Expert Review of Cardiovascular Therapy·Laurent DavinPatrizio Lancellotti
Nov 23, 2016·Journal of Cardiovascular Medicine·Giuseppe Di PasqualeSilvia Zagnoni
Mar 28, 2017·Echocardiography·Peerawut Deeprasertkul, Masood Ahmad
Aug 17, 2019·Circulation. Cardiovascular Interventions·Hannah Z R McConkeyBernard D Prendergast
Jan 17, 2020·European Heart Journal Cardiovascular Imaging·Issa Farah IssaJacob Eifer Møller
Mar 16, 2017·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Frédéric MaesJean-Louis Vanoverschelde
May 7, 2019·Circulation·Yogesh N V Reddy, Rick A Nishimura
May 26, 2017·Clinical Cardiology·Anja VogelgesangClaudius Jacobshagen
Oct 19, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Yujing MoMartin Penicka
Jul 8, 2016·Current Cardiology Reports·Sveeta BadianiGuy Lloyd
Jul 4, 2018·Scientific Reports·Iacopo FabianiVitantonio Di Bello
Jan 18, 2021·JACC. Cardiovascular Imaging·Patricia A Pellikka, Jordi S Dahl
Feb 16, 2021·Current Problems in Cardiology·João AbecasisAna Félix
Jul 12, 2020·The American Journal of Cardiology·Gagandeep ChadhaChristophe Tribouilloy
Apr 25, 2020·Journal of the American College of Cardiology·Ezequiel GuzzettiMarie-Annick Clavel
Sep 18, 2021·The International Journal of Cardiovascular Imaging·Mihai Strachinaru, Nicolas M Van Mieghem

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