Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits

• DOI: 10.3389/fcvm.2022.852954
• Publication Date: 2022-04-01T10:53:28Z
• Authors: Laura Galian-Gay; Roxana Andreina E...; Gisela Teixidó-Turà; Guillem Casas; Elena Ferrer-Sistach; Cristina Mitroi; Susana Mingo; Vanessa Monivas; Daniel Saura; Bàrbara Vidal; Livia Trasca; Sergio Moral; Francisco Calvo; Maria Castiñeira ...; Violeta Sánchez; Ariana Gonzalez; Gabriela Guzman; Marta Noris Mora; MiguelÁngel Arnau...; Jesús Peteiro; Alberto Bouzas; Aleksandra Mas-St...; Teresa González-A...; Laura Gutiérrez; Rubén Fernandez-G...; Filipa Valente; Andrea Guala; Aroa Ruiz-Muñoz; Cesar Augusto Sao...; José F. Rodríguez...; Ignacio Ferreira; Artur Evangelista
• Keywords: Vàlvula aòrtica - Estenosi - Prognosi; heart valve disease; aortic valve surgery; Cardiovascular Medicine; 03 medical and health sciences; 0302 clinical medicine; Vàlvula aòrtica - Estenosi - Cirurgia; Diseases of the circulatory (Cardiovascular) system; echocardiography; :Cardiovascular Diseases::Heart Diseases::Heart Valve Diseases::Aortic Valve Stenosis [DISEASES]; :Diagnosis::Prognosis [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT]; Aortic valve surgery; Paradoxical low-flow low-gradient; :diagnóstico::pronóstico [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]; Aortic stenosis; paradoxical low-flow low-gradient; aortic stenosis; :Otros calificadores::Otros calificadores::/cirugía [Otros calificadores]; Heart valve disease; :Other subheadings::Other subheadings::/surgery [Other subheadings]; 3. Good health; :enfermedades cardiovasculares::enfermedades cardíacas::enfermedades de las válvulas cardíacas::estenosis de la válvula aórtica [ENFERMEDADES]; Echocardiography; RC666-701

To determine the risk of mortality and need for aortic valve replacement (AVR) in patients with low-flow low-gradient (LFLG) stenosis (AS).A longitudinal multicentre study including consecutive severe AS (aortic area [AVA] < 1.0 cm2) normal left ventricular ejection fraction (LVEF). Patients were classified as: high-gradient (HG, mean gradient ≥ 40 mmHg), normal-flow (NFLG, mmHg, indexed systolic volume (SVi) > 35 ml/m2) LFLG (mean SVi ≤ ml/m2).Of 1,391 patients, 147 (10.5%) had LFLG, 752 (54.1%) HG, 492 (35.4%) NFLG. Echocardiographic parameters group showed similar AVA to HG but less severity dimensionless index, calcification, hypertrophy. The required AVR earlier than NFLG (p 0.001) 0.001), no differences between groups = 0.358). Overall was 27.7% (CI 95% 25.3-30.1) among 0.319). impact terms overall reduction observed most (hazard ratio [HR]: 0.17; CI: 0.12-0.23; p followed by (HR: 0.25; 0.13-0.49; finally 0.29; 0.20-0.44; a 84, 75, 71%, respectively.Paradoxical affects 10.5% AS, has lower group, mortality. on compared AS. Therefore, findings present have an intermediate clinical profile NFHG groups.