Progression of Low-Gradient, Low-Flow, Severe Aortic Stenosis With Preserved Left Ventricular Ejection Fraction

• Published in: The American journal of cardiology 2015-08, Vol.116 (4), p.612-617
• Main Authors: Tribouilloy, Christophe, MD, PhD, Rusinaru, Dan, MD, PhD, Charles, Vincent, MD, Boulif, Jamila, MS, Maes, Frédéric, MD, Lévy, Franck, MD, Pasquet, Agnès, MD, PhD, Maréchaux, Sylvestre, MD, PhD, Vanoverschelde, Jean-Louis, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - physiopathology; Blood Flow Velocity - physiology; Calcification; Cardiology; Cardiovascular; Cardiovascular disease; Coronary vessels; Disease Progression; Echocardiography, Doppler; Female; Follow-Up Studies; Heart rate; Humans; Male; Retrospective Studies; Severity of Illness Index; Stroke; Stroke Volume - physiology; Studies; Time Factors; Variables; Velocity; Ventricular Function, Left - physiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2015.05.023

Low-gradient (LG), low-flow (LF), severe aortic stenosis (AS) with preserved ejection fraction (PEF) is considered by some authors as an advanced form of AS associated with very poor outcome. The aim of this Doppler echocardiographic study was to investigate changes over time in the hemodynamic severity of LG/LF AS with PEF. We retrospectively identified in 2 academic centers 59 patients who had 2 Doppler echocardiographic examinations without an intervening event. After a median follow-up of 2 (interquartile range [IQR] 1.3 to 3.5) years, progression was observed with increase in mean Doppler gradient (MDG; from 27 [23 to 32] to 37 [28 to 44] mm Hg; p