The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Flow-Gradient Patterns in Severe Aortic Stenosis With Preserved Ejection Fraction: Clinical Characteristics and Predictors of Survival
Open accessAbstract
Background—: Among patients with severe aortic stenosis (AS) and preserved ejection fraction, those with low gradient (LG) and reduced stroke volume may have an adverse prognosis. We investigated the prognostic impact of stroke volume using the recently proposed flow-gradient classification. Methods and Results—: We examined 1704 consecutive patients with severe AS (aortic valve area <1.0 cm 2 ) and preserved ejection fraction (≥50%) using 2-dimensional and Doppler echocardiography. Patients were stratified by stroke volume index (<35 mL/m 2 [low flow, LF] versus ≥35 mL/m 2 [normal flow, NF]) and aortic gradient (<40 mm Hg [LG] versus ≥40 mm Hg [high gradient, HG]) into 4 groups: NF/HG, NF/LG, LF/HG, and LF/LG. NF/LG (n=352, 21%), was associated with favorable survival with medical management (2-year estimate, 82% versus 67% in NF/HG; P <0.0001). LF/LG severe AS (n=53, 3%) was characterized by lower ejection fraction, more prevalent atrial fibrillation and heart failure, reduced arterial compliance, and reduced survival (2-year estimate, 60% versus 82% in NF/HG; P <0.001). In multivariable analysis, the LF/LG pattern was the strongest predictor of mortality (hazard ratio, 3.26; 95% confidence interval, 1.71–6.22; P <0.001 versus NF/LG). Aortic valve replacement was associated with a 69% mortality reduction (hazard ratio, 0.31; 95% confidence interval, 0.25–0.39; P <0.0001) in LF/LG and NF/HG, with no survival benefit associated with aortic valve replacement in NF/LG and LF/HG. Conclusions—: NF/LG severe AS with preserved ejection fraction exhibits favorable survival with medical management, and the impact of aortic valve replacement on survival was neutral. LF/LG severe AS is characterized by a high prevalence of atrial fibrillation, heart failure, and reduced survival, and aortic valve replacement was associated with improved survival. These findings have implications for the evaluation and subsequent management of AS severity.
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Self-citationGuidelines on the management of valvular heart disease (version 2012)
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Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice
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Self-citationHachicha, Z., Dumesnil, J. G., Bogaty, P., & Pibarot, P. (2007) · Circulation · doi:10.1161/circulationaha.106.668681 · Cited by 959
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Inconsistencies of echocardiographic criteria for the grading of aortic valve stenosis
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Clinical Outcome in Asymptomatic Severe Aortic Stenosis
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Cited by
2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease
Nishimura, R. A., Otto, C. M., Bonow, R. O., Carabello, B. A., Erwin, J. P., Guyton, R. A., O’Gara, P. T., Ruiz, C. E., Skubas, N. J., Sorajja, P., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.02.536 · Cited by 3,523
Self-citationNishimura, R. A., Otto, C. M., Bonow, R. O., Carabello, B. A., Erwin, J. P., Guyton, R. A., O’Gara, P. T., Ruiz, C. E., Skubas, N. J., Sorajja, P., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000029 · Cited by 2,566
Self-citation2014 AHA/ACC guideline for the management of patients with valvular heart disease
Nishimura, R. A., Otto, C. M., Bonow, R. O., Carabello, B. A., Erwin, J. P., Guyton, R. A., O’Gara, P. T., Ruiz, C. E., Skubas, N. J., Sorajja, P., et al. (2014) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2014.05.014 · Cited by 989
Self-citationBaumgartner, H., Hung, J., Bermejo, J., Chambers, J. B., Edvardsen, T., Goldstein, S., Lancellotti, P., LeFevre, M., Miller, F., & Otto, C. M. (2017) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jew335 · Cited by 760
JCS/JSCS/JATS/JSVS 2020 Guidelines on the Management of Valvular Heart Disease
Izumi, C., Eishi, K., Ashihara, K., Arita, T., Otsuji, Y., Kunihara, T., Komiya, T., Shibata, T., Seo, Y., Daimon, M., et al. (2020) · Circulation Journal · doi:10.1253/circj.cj-20-0135 · Cited by 367
Metadata
- Authors
- Eleid, M. F., Sorajja, P., Michelena, H. I., Malouf, J. F., Scott, C. G., & Pellikka, P. A.
- Venue
- Circulation
- Published
- 2013-10-15
- Volume
- 128
- Issue
- 16
- Pages
- 1781-1789
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2019380056
- Cited by
- 324
- References
- 18
- FWCI
- 20.13
- Type
- journal article
- Language
- en
- Open access
- green
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- Eleid, M. F., Sorajja, P., Michelena, H. I., Malouf, J. F., Scott, C. G., & Pellikka, P. A. (2013). Flow-Gradient Patterns in Severe Aortic Stenosis With Preserved Ejection Fraction: Clinical Characteristics and Predictors of Survival. Circulation. https://doi.org/10.1161/circulationaha.113.003695
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