Differences in natural history of low- and high-gradient aortic stenosis from nonsevere to severe stage of the disease

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Sebastian HerrmannFrank Weidemann

Abstract

The aim of the present study was to assess and compare the disease progression of aortic stenosis (AS) subtypes from nonsevere to severe disease on the basis of measures of gradient and flow. Seventy-seven patients with AS (mean aortic valve area, 1.3 ± 0.3 cm(2) at baseline) underwent echocardiographic examination, including two-dimensional speckle-tracking strain measurements. Patients were retrospectively grouped according to mean transvalvular pressure gradient (40 mm Hg) into low-gradient (LG/AS) and high-gradient (HG/AS) groups. The LG/AS group was further subdivided into low-flow (LF/LG; i.e., stroke volume index < 35 mL/m(2)) and normal-flow (NF/LG) groups. For subanalysis, the LF/LG group was split into two groups: "paradoxical" (P-LF/LG; ejection fraction > 50%) and "classical" LF/LG (C-LF/LG; ejection fraction < 50%). Follow-up echocardiography was performed in patients with severe AS after 3.3 ± 1.7 years. Survival status was ascertained after 5.0 ± 2.0 years. Coronary artery disease was more frequent in LG/AS than HG/AS patients. Already at baseline, LF/LG patients showed reduced left ventricular global systolic strain and reduced systemic arterial compliance compared with HG/AS patients (HG/AS, 1.0 ± 0.4 mL · mm H...Continue Reading

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Citations

Jan 23, 2017·The American Journal of Medicine·Edgar ArgulianFranz H Messerli
Aug 23, 2017·Future Cardiology·Lucy M SafiMichael H Picard
Aug 17, 2019·Circulation. Cardiovascular Interventions·Hannah Z R McConkeyBernard D Prendergast
Aug 11, 2018·Heart Failure Reviews·Chirag BavishiJ Dawn Abbott
Nov 9, 2020·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Saki ItoJae K Oh

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