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

Paradoxical low-flow, low-gradient aortic stenosis: new evidence, more questions.

Role of Transesophageal Echocardiography in the Diagnosis of Paradoxical Low Flow, Low Gradient Severe Aortic Stenosis

BACKGROUND AND OBJECTIVES Prior studies indicate that up to 35% of cases of severe aortic stenosis (AS) have paradoxical low flow, low gradient despite preserved left ventricular ejection fraction (LVEF). However, error in left ventricular outflow tract (LVOT) diameter may lead to misclassification. Herein, we determined whether measurement of LVOT diameter by transesophageal echocardiography (...

Management of paradoxical low-flow, low-gradient aortic stenosis: need for an integrated approach, including assessment of symptoms, hypertension, and stenosis severity.

SEE PAGE 55 I n 2007, we reported that a substantial proportion of patients with severe aortic stenosis may have a low flow (LF) (i.e., reduced stroke volume), and thus, often have a low transvalvular pressure gradient (LG), despite a preserved left ventricular ejection fraction (LVEF) (1). The 2014 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines (2) classified ...

Aortic stenosis: new thoughts on a cardiac disease of older people.

We have entered a new era in understanding degenerative aortic stenosis in elderly patients. With the aging of the US population and the progressive decrease in coronary heart disease prevalence in the past 50 years, aortic stenosis has become a major cardiac concern. New perspectives of the disease now lead us to see the condition in terms of the response of the left ventricle and of systemic ...

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...