Stroke volume index and outcomes in low gradient severe aortic stenosis
نویسندگان
چکیده
Abstract Background Conventionally, stroke volume index (SVI) ≤35ml/m2 is considered as “low-flow” in severe aortic stenosis (AS). Recent evidence suggests a lower threshold SVI (30ml/m2) may be more prognostically informative. Objectives To assess the association between and survival patients with low-gradient AS, either preserved (LVEF ≥50%) or reduced (LVEF<50%) ejection fraction. Methods Data were derived from National Echocardiography Database of Australia (NEDA). Of 192,060 adults (aged 62.8±17.8 years) comprehensive valve profiling 2000–2019, 12,013 (6.3%) had AS. Based on standard echocardiographic parameters, 1,623 AS LVEF 744 LVEF. All-cause cardiovascular-related mortality assessed for each group an adjusted basis (age, sex, BMI, AVA indexed RVSP), according to SVI. Mean follow-up was 81±42 months. Results Compared “normal” flow (SVI >35ml/m2), those ≤35ml/m2) significantly higher smaller AV mean gradient peak velocity (p≤0.001). In patients, at 1- 3-years only ≤30ml/m2 compared SVI>35ml/m2 (p<0.001 p<0.03, respectively). (p=0.015 p=0.018, Conclusions Taken together previous data, our results suggest that (rather than ≤35 ml/m2) significant Funding Acknowledgement Type funding sources: None. Survival plots LGAS EFSummary
منابع مشابه
Survival by stroke volume index in patients with low-gradient normal EF severe aortic stenosis.
OBJECTIVE Low-gradient (LG) severe aortic stenosis (AS) and preserved EF with reduced stroke volume are associated with an adverse prognosis, but the relationship of stroke volume index (SVI) with mortality among a range of values is unknown. We investigated the prognostic impact of SVI in this population. METHODS We examined 405 consecutive patients with preserved EF (≥50%) and severe AS (va...
متن کاملPredictors of Outcomes in Low-Flow, Low-Gradient Aortic Stenosis
Background—Patients with low-flow, low-gradient aortic stenosis have a poor prognosis with conservative therapy but a high operative mortality if treated surgically. Recently, we proposed a new index of aortic stenosis severity derived from dobutamine stress echocardiography, the projected aortic valve area at a normal transvalvular flow rate, as superior to other conventional indices to differ...
متن کاملLow-gradient aortic stenosis
Low-gradient aortic stenosis (AS) has been a vexing problem for cardiologists since its original description in 1980 by Carabello et al.1 In that study, 3 of 4 patients with low-gradient AS died at surgery, and the other patient had persistent severe heart failure postoperatively. Subsequent studies showed that although operative mortality is high, most patients survive aortic valve replacement...
متن کاملClinical presentation and outcomes after transcatheter aortic valve implantation in patients with low flow/low gradient severe aortic stenosis.
OBJECTIVES To identify predictors of mortality, functional status, and hemodynamical changes of patients undergoing transcatheter aortic valve implantation (TAVI) for low flow/low gradient aortic stenosis (LF/LG AS). BACKGROUND There is little published data regarding the outcomes of patients with LF/LG AS following TAVI. METHODS Sixty-eight patients with severe AS, left ventricular dysfunc...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: European Heart Journal
سال: 2021
ISSN: ['2634-3916']
DOI: https://doi.org/10.1093/eurheartj/ehab724.1674