2026-04-29T04:09:16Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/235022024-11-29T05:02:16Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967
Repisalud
author
Galian Gay, Laura
author
Escalona Silva, Roxana Andreina
author
Teixidó-Turà, Gisela
author
Casas, Guillem
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Ferrer-Sistach, Elena
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Mitroi, Cristina
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Mingo, Susana
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Monivas, Vanessa
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Saura, Daniel
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Vidal, Bàrbara
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Trasca, Livia
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Moral, Sergio
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Calvo, Francisco
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Castiñeira Busto, Maria
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Sánchez, Violeta
author
Gonzalez, Ariana
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Guzman, Gabriela
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Noris Mora, Marta
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Arnau Vives, MiguelÁngel
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Peteiro, Jesús
author
Bouzas, Alberto
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Mas-Stachurska, Aleksandra
author
González-Alujas, Teresa
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Gutiérrez, Laura
author
Fernandez-Galera, Rubén
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Valente, Filipa
author
Guala, Andrea
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Ruiz-Muñoz, Aroa
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Avilés, Cesar Augusto Sao
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Rodríguez-Palomares, José F
author
Ferreira, Ignacio
author
Evangelista, Arturo
2024-10-04T13:46:28Z
2024-10-04T13:46:28Z
2022
Galian-Gay L, Escalona Silva RA, Teixidó-Turà G, Casas G, Ferrer-Sistach E, Mitroi C, et al. Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits. Front Cardiovasc Med. 2022 Apr 1;9.
2297-055X
http://hdl.handle.net/20.500.13003/18082
https://hdl.handle.net/20.500.12105/23502
35433871
10.3389/fcvm.2022.852954
Frontiers in cardiovascular medicine
806264400001
Objectives: To determine the risk of mortality and need for aortic valve replacement (AVR) in patients with low-flow low-gradient (LFLG) aortic stenosis (AS). Methods: A longitudinal multicentre study including consecutive patients with severe AS (aortic valve area [AVA] < 1.0 cm2) and normal left ventricular ejection fraction (LVEF). Patients were classified as: high-gradient (HG, mean gradient ≥ 40 mmHg), normal-flow low-gradient (NFLG, mean gradient < 40 mmHg, indexed systolic volume (SVi) > 35 ml/m2) and LFLG (mean gradient < 40 mmHg, SVi ≤ 35 ml/m2). Results: Of 1,391 patients, 147 (10.5%) had LFLG, 752 (54.1%) HG, and 492 (35.4%) NFLG. Echocardiographic parameters of the LFLG group showed similar AVA to the HG group but with less severity in the dimensionless index, calcification, and hypertrophy. The HG group required AVR earlier than NFLG (p < 0.001) and LFLG (p < 0.001), with no differences between LFLG and NFLG groups (p = 0.358). Overall mortality was 27.7% (CI 95% 25.3-30.1) with no differences among groups (p = 0.319). The impact of AVR in terms of overall mortality reduction was observed the most in patients with HG (hazard ratio [HR]: 0.17; 95% CI: 0.12-0.23; p < 0.001), followed by patients with LFLG (HR: 0.25; 95% CI: 0.13-0.49; p < 0.001), and finally patients with NFLG (HR: 0.29; 95% CI: 0.20-0.44; p < 0.001), with a risk reduction of 84, 75, and 71%, respectively. Conclusions: Paradoxical LFLG AS affects 10.5% of severe AS, and has a lower need for AVR than the HG group and similar to the NFLG group, with no differences in mortality. AVR had a lower impact on LFLG AS compared with HG AS. Therefore, the findings of the present study showed LFLG AS to have an intermediate clinical risk profile between the HG and NFHG groups.
eng
Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits
research article