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Patients with paradoxical low-flow, low-gradient aortic stenosis gain the least benefit from TAVI among all hemodynamic subtypes.
Clin Res Cardiol
July 2024
Clinic of Cardiology and Pneumology, University Medical Center Göttingen, 37099, Göttingen, Germany.
Background: Substantial controversy exists regarding the clinical benefit of patients with severe paradoxical low-flow, low-gradient aortic stenosis (PLF-LG AS) from TAVI. Therefore, we compared post-TAVI benefit by long-term mortality (all-cause, CV and SCD), clinical improvement of heart failure symptoms, and cardiac reverse remodelling in guideline-defined AS subtypes.
Methods: We prospectively included 250 consecutive TAVI patients.
Aortic valve calcification and myocardial fibrosis determine outcome following transcatheter aortic valve replacement.
ESC Heart Fail
August 2023
Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Georg August University of Göttingen, Göttingen, Germany.
Aims: There is evidence to suggest that the subtype of aortic stenosis (AS), the degree of myocardial fibrosis (MF), and level of aortic valve calcification (AVC) are associated with adverse cardiac outcome in AS. Because little is known about their respective contribution, we sought to investigate their relative importance and interplay as well as their association with adverse cardiac events following transcatheter aortic valve replacement (TAVR).
Methods And Results: One hundred consecutive patients with severe AS and indication for TAVR were prospectively enrolled between January 2017 and October 2018.
Direct proteomic and high-resolution microscopy biopsy analysis identifies distinct ventricular fates in severe aortic stenosis.
J Mol Cell Cardiol
December 2022
Clinic of Cardiology & Pneumology, University Medical Center Göttingen, Germany; Cellular Biophysics & Translational Cardiology Section, Heart Research Center Göttingen, University Medical Center Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Germany; Collaborative Research Center SFB1002 "Modulatory Units in Heart Failure", University of Göttingen, Germany; Collaborative Research Center SFB1190 "Compartmental Gates and Contact Sites in Cells", University of Göttingen, Germany; Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen, Germany; Leducq Transatlantic Network of Excellence CURE-PLaN, Clinic of Cardiology & Pneumology, University Medical Center Göttingen, Germany. Electronic address:
The incidence of aortic valve stenosis (AS), the most common reason for aortic valve replacement (AVR), increases with population ageing. While untreated AS is associated with high mortality, different hemodynamic subtypes range from normal left-ventricular function to severe heart failure. However, the molecular nature underlying four different AS subclasses, suggesting vastly different myocardial fates, is unknown.
View Article and Find Full Text PDFPassive Leg Raise Stress Echocardiography in Severe Paradoxical Low-Flow, Low-Gradient Aortic Stenosis.
J Am Soc Echocardiogr
November 2022
Department of Cardiology, University Hospital, Bern, Switzerland. Electronic address:
Background: Dobutamine stress echocardiography is used to increase transvalvular flow in patients with low-flow, low-gradient aortic stenosis (AS). Dobutamine fails to increase the stroke volume index (SVI) in one third of patients. The aim of this study was to test whether passive leg raise (PLR) added to dobutamine could increase SVI and transvalvular flow in patients with severe paradoxical low-flow, low-gradient AS.
View Article and Find Full Text PDFSevere aortic stenosis echocardiographic thresholds revisited.
Echocardiography
December 2021
The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Background: In view of inconsistencies in threshold values of severe aortic stenosis (AS) hemodynamic indices, it is unclear what is the relative contribution of each variable in a binary classification of AS based on aortic valve replacement (AVR) indication. We aimed to assess relative discriminative value and optimal threshold of each constituent hemodynamic parameter for this classification and confirm additional prognostic value.
Methods: Echocardiography studies of 168 patients with ≥ moderate AS were included.
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