Abstract
The diagnosis of severe aortic stenosis (AS) is challenging when a small aortic valve area (AVA) is associated with low gradients not consistent with severe AS. Low-gradient AS (LGAS) is present in a significant proportion of patients with AS and is commonly due to low forward flow states. Atrial fibrillation (AF) is associated with lower forward flow compared with sinus rhythm (SR)1 and may result in underestimation of AS severity by the flow-dependent mean gradient (MG).2-4 We aimed to compare forward flow parameters and transaortic valve MG in the same patient(s) during AF versus SR.
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