Conversion from low pressure gradient to high pressure gradient is an ominous prognostic sign in patients with paradoxical low flow low pressure gradient severe aortic stenosis

Paradoxical Low-Flow, Low-Gradient Aortic Stenosis

Low-flow, low-gradient aortic stenosis (AS) is a highly challenging condition in terms of diagnosis and therapeutic management. The transvalvular pressure gradient is inversely related to the square of aortic valve area (AVA) and directly related to the square of flow. Hence, a patient with severe AS may nonetheless present with a low gradient if his or her left ventricular (LV) output is reduc...

Paradoxical Low - Flow , Low - Gradient Aortic Stenosis : New

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High- Versus Low-Gradient Severe Aortic Stenosis

Low "gradient", low flow aortic stenosis.

Correspondence to: Dr John Chambers, Cardiothoracic Centre, St Thomas Hospital, London SE1 7EH, UK; jboydchambers@ aol.com _________________________ A ortic stenosis is thought to have a long, asymptomatic latent phase during which the risk of sudden death is low. In fact symptoms can be revealed by treadmill exercise in a large proportion of apparently asymptomatic patients. Patients may limit...

Natural history of paradoxical low-gradient severe aortic stenosis.

BACKGROUND Up to 30% of patients with severe aortic stenosis (SAS; indexed aortic valve area <0.6 cm(2)/m(2)) present with low transvalvular gradient despite a normal left ventricular ejection fraction. Presently, there is intense controversy as to the prognostic implications of such findings. Accordingly, the aim of the present work was to compare the natural history of patients with paradoxic...