Paradoxical low-flow, low-gradient aortic stenosis adding new pieces to the puzzle

Authors: Pibarot, PhilippeDumesnil, Jean G.
Abstract: Low-flow, low-gradient aortic stenosis (AS) is a highly challenging condition in terms of diagnosis and therapeutic management. The transvalvular pressure gradient is inversely related to the square of aortic valve area (AVA) and directly related to the square of flow. Hence, a patient with severe AS may nonetheless present with a low gradient if his or her left ventricular (LV) output is reduced. This situation is frequently observed in patients with depressed LV ejection fraction (LVEF) who often have a low transvalvular flow and thus a low gradient despite the presence of severe AS. Conversely, it is generally assumed that patients with severe AS and preserved LVEF should necessarily have a high transvalvular gradient. However, recent studies revealed that this perception is erroneous and that a substantial proportion of patients with severe AS may indeed have a low transvalvular flow and thus a low gradient despite a preserved LVEF
Document Type: Article de recherche
Issue Date: 19 July 2011
Open Access Date: Restricted access
Document version: VoR
This document was published in: Journal of the American College of Cardiology, Vol. 58 (4), 413-415 (2011)
Alternative version: 10.1016/j.jacc.2011.01.057
Collection:Articles publiés dans des revues avec comité de lecture

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