Prognosis of low-flow low-gradient aortic valve stenosis with atrial fibrillation

Abstract Background Patients with Low-flow low-gradient (LFLG) aortic valve stenosis (AS) have possibly poor prognosis. Recently, it was reported that the LFLG AS patients similar outcomes compared to high-gradient (HG) but worse normal-flow [NFLG: SVi≥35 ml/m2, mPG <40mmHg] subgroup. The main determinant of LF state in severe preserved LVEF are male gender, heart rate, LV volume and atrial fibrillation (AF). However, relationship between comorbidity AF risk failure (HF) remains unclear. Purpose We elucidated about prognosis AF. Methods included 225 consecutive (SAS, iAVA<0.6 cm2/m2) from 2013 2020. Among these patients, SAS [HG-SAS; mean pressure gradient (mPG) ≥40 mmHg, n=88] [stroke index (SVi) ≤35 <40 n=82] extracted baseline characteristics including presence or absence were evaluated. primary endpoint worsening HF required unplanned hospitalization readjustment drug therapy. Results HG AS, observed 65 patients. exhibited a higher oral rate renin-angiotensin-system inhibitors (p=0.02). In addition, SVi E/e' lower [SVi; 29.4 (24.4–34.0) versus 37.7 (28.2–45.3), p<0.0001, E/E'; 16.0 (13.1–21.5) vs 20.9 (16.0–27.4), p=0.002]. There is no differences 2 groups prevalence. Furthermore, subdivided as follow; (n=25), without (n=63), (n=24), (n=58). Kaplan Meier curves demonstrated experienced equivalent (log rank, p<0.001). Cox hazard analysis among paroxysmal (pAF, n=12) instead chronic (cAF, showed for those (HR 5.0; 95% CI, 1.8–14; p=0.0028, HR 1.9; 0.62–5.8; p=0.26, respectively). Conclusion pAf associated an increased LFLF AS. Thus, intervention drugs catheter ablation pAF could lead prevent clinical outcomes. Funding Acknowledgement Type funding sources: None.