Abstract
Aortic stenosis (AS) represents the most commonly encountered valvular heart disease. Traditionally, severe AS is defined by an aortic valve area (AVA) less than or equal to 1.0 cm2 and mean aortic valve gradient (MG) greater than or equal to 40 mm Hg. In roughly 40% of encountered cases, however, Doppler echocardiography yields discordant findings—a calculated AVA suggestive of severe AS but a MG consistent with less-than-severe disease [ [1] Minners J. Allgeier M. Gohlke-Baerwolf C. Kienzle R.P. Neumann F.J. Jander N. Inconsistencies of echocardiographic criteria for the grading of aortic valve stenosis. Eur. Heart J. 2008 Apr; 29: 1043-1048https://doi.org/10.1093/eurheartj/ehm543 Crossref PubMed Scopus (259) Google Scholar , [2] Sen J. Manning T. Innes-Jones K. Neil C. Marwick T.H. Temporal trends in detection and outcomes of low-flow and low-gradient aortic stenosis. JACC Cardiovasc. Imaging. 2020 Dec; 13: 2682-2684https://doi.org/10.1016/j.jcmg.2020.06.012 Crossref PubMed Scopus (1) Google Scholar ]. Assuming no error in measurement, these cases stem, in part, from low-flow states (defined as a resting stroke volume index, SVI, less than or equal to 35 mL/m2) and constitute low-flow low-gradient (LFLG) severe AS. Predictors of true-severe classical low-flow low-gradient aortic stenosis at resting echocardiographyInternational Journal of CardiologyVol. 335PreviewClassical low-flow, low-gradient (LF/LG) aortic stenosis (AS) is subclassified into a true-severe (TS) and a pseudo-severe (PS) subform using low-dose dobutamine stress echocardiography (DSE). In clinical practice a resting peak jet velocity (Vmax) >3.5 m/s or a mean transvalvular gradient (MPG) >35 mmHg suggests the presence of TS classical LF/LG AS, but there is no data to support this. The aim of this study was therefore to investigate whether a resting Vmax >3.5 m/s or MPG >35 mmHg reliably predicted diagnosis of TS classical LF/LG AS. Full-Text PDF
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