Paradoxical low flow and/or low gradient severe aortic stenosis despite preserved left ventricular ejection fraction : implications for diagnosis and treatment

Authors: Dumesnil, Jean G.Pibarot, Philippe; Carabello, Blase
Abstract: Paradoxical low flow, low gradient, severe aortic stenosis (AS) despite preserved ejection fraction is a recently described clinical entity whereby patients with severe AS on the basis of aortic valve area have a lower than expected gradient in relation to generally accepted values. This mode of presentation of severe AS is relatively frequent (up to 35% of cases) and such patients have a cluster of findings, indicating that they are at a more advanced stage of their disease and have a poorer prognosis if treated medically rather than surgically. Yet, a majority of these patients do not undergo surgery likely due to the fact that the reduced gradient is conducive to an underestimation of the severity of the disease and/or of symptoms. The purpose of this article is to review and further analyse the distinguishing characteristics of this entity and to present its implications with regards to currently accepted guidelines for AS severity.
Document Type: Article de recherche
Issue Date: 8 September 2009
Open Access Date: Restricted access
Document version: VoR
This document was published in: European Heart Journal, Vol. 31 (3), 281–289 (2010)
European Society of Cardiology
Alternative version: 10.1093/eurheartj/ehp361
Collection:Articles publiés dans des revues avec comité de lecture

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