Potential Impact of Concomitant Valvular Lesions and Coronary Artery Bypass Surgery on Outcome in Low-Gradient Severe Aortic Stenosis With Preserved Ejection Fraction

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Outcome of patients with low-gradient "severe" aortic stenosis and preserved ejection fraction.

BACKGROUND Retrospective studies have suggested that patients with a low transvalvular gradient in the presence of an aortic valve area < 1.0 cm² and normal ejection fraction may represent a subgroup with an advanced stage of aortic valve disease, reduced stroke volume, and poor prognosis requiring early surgery. We therefore evaluated the outcome of patients with low-gradient "severe" stenosis...

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Preserved ejection fraction can accompany low gradient severe aortic stenosis: impact of pathophysiology on diagnostic imaging.

Grading the severityof aortic stenosis (AS) on the basis of aortic valve area (AVA), mean pressure gradient, and left ventricular (LV) ejection fraction (EF) at rest and under stress was believed to be a straightforward matter, an approach also permitting discrimination between ‘classic’ low gradient/low output AS and pseudo-severe AS. If we are still accustomed to equate LVEF with systolic fun...

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Invasive measures of afterload in low gradient severe aortic stenosis with preserved ejection fraction.

BACKGROUND The pathophysiology of low flow, low gradient severe aortic stenosis (LGSAS) with preserved ejection fraction is poorly understood. It has been proposed that abnormalities of arterial circulation are a major contributor to this syndrome. METHODS AND RESULTS We invasively examined systemic arterial afterload (effective arterial elastance, Ea; total arterial compliance, Ca; and syste...

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Low gradient severe aortic stenosis with normal ejection fraction.

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Severe aortic valve stenosis with low-gradient and preserved ejection fraction: a misclassification issue?

INTRODUCTION AND OBJECTIVES Low-gradient severe aortic stenosis with preserved ejection fraction is a controversial entity. Misclassification of valvulopathy severity could explain the inconsistencies reported in the prognosis of these patients. Planimetry of the aortic area using three-dimensional transesophageal echocardiography could clear up these doubts. The objectives were to assess the a...

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ژورنال

عنوان ژورنال: Journal of the American College of Cardiology

سال: 2013

ISSN: 0735-1097

DOI: 10.1016/j.jacc.2012.10.058