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| http://dx.doi.org/10.1016/j.jacadv.2023.100640 | DOI Listing |
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Low-Gradient Severe Aortic Stenosis Is Not Mainstream: Insights From the CURRENT AS Registry-2.
JACC Cardiovasc Interv
November 2024
Institut Universitaire de Cardiologie et de Pneumologie, Université Laval, Quebec City, Quebec, Canada. Electronic address:
Low-Gradient Severe Aortic Stenosis: Insights From the CURRENT AS Registry-2.
JACC Cardiovasc Interv
November 2024
Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan. Electronic address:
Background: Low-gradient (LG) aortic stenosis (AS) has not been fully characterized compared with high-gradient (HG) AS in terms of cardiac damage, frailty, aortic valve calcification, and clinical outcomes.
Objectives: The aim of this study was to compare the clinical characteristics and outcomes between each hemodynamic type of LG AS and HG AS.
Methods: The current study included 3,363 patients in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) Registry-2 after excluding patients without indexed stroke volume or left ventricular ejection fraction (LVEF) data.
Impact of Flow-Gradient Patterns on Outcomes of Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis with Preserved Left Ventricular Ejection Fraction.
Int Heart J
November 2024
Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research.
To compare the clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS) and preserved ejection fraction (pEF) according to flow-gradient status.This retrospective study focused on patients with severe AS and pEF (≥ 50%) undergoing TAVR with newer generation valves (Sapien3/3 Ultra, Evolut Pro/Pro+/FX) between 2018 and 2022 (n = 781). Patients were divided into 3 groups: normal-flow high-gradient (NF-HG, stroke volume index ≥ 35 mL/m and mean pressure gradient ≥ 40 mmHg or peak velocity ≥ 4 m/second), low-flow high-gradient (LF-HG), and paradoxical low-flow low-gradient (pLF-LG) groups.
View Article and Find Full Text PDFPrognostic Relevance of Gradient and Flow Status in Severe Aortic Stenosis.
J Clin Med
October 2024
Cardiology Department, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
Article Synopsis
- The study focuses on severe aortic stenosis (AS), particularly the paradoxical low-flow low-gradient (PLF-LG) type, which has unique characteristics and uncertain management and prognosis.
- It analyzed 205 patients diagnosed with severe AS at a hospital in 2021, categorizing them into four groups: high gradient (HG), concordant low-flow low-gradient (CLF-LG), PLF-LG, and normal-flow low-gradient (NF-LG).
- Findings indicated that PLF-LG patients had a significantly higher mortality rate despite similar intervention rates compared to those with high gradient AS, suggesting a need for closer monitoring and early intervention for this group.
Changes and Prognostic Implications of Myocardial Work in Aortic Stenosis Subtypes Undergoing Transcatheter Valve Implantation.
JACC Adv
August 2024
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Background: Evaluation of left ventricle (LV) systolic function in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) is challenging, as LV ejection fraction (LVEF) and global longitudinal strain are afterload dependent. LV global work indices (GWIs) estimate the afterload corrected systolic function.
Objectives: The purpose of this study was to evaluate changes in and prognostic implications of GWIs in subtypes of AS patients before and 1 month after TAVI.
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