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low flow low gradient aortic stenosis

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https://www.readbyqxmd.com/read/28735253/how-should-i-treat-a-patient-with-a-symptomatic-and-severe-low-flow-low-gradient-aortic-stenosis-and-an-incidental-abdominal-aortic-aneurysm
#1
Zouhair Rahhab, Sander Ten Raa, Nathalie van der Ploeg, Nicolas M Van Mieghem, Hence Verhagen, Peter P T de Jaegere, Mani Arsalan, Won Kim, Thomas Walther, Didier Tchétché
No abstract text is available yet for this article.
July 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28715078/polish-stress-echocardiography-registry-pol-stress-registry-a-multicenter-study-stress-echo-in-poland-numbers-settings-results-and-complications
#2
Edyta Płońska-Gościniak, Jarosław D Kasprzak, Szymon Olędzki, Jolanta Rzucidło-Resil, Piotr Gościniak, Tomasz Kukulski, Katarzyna Mizia-Stec, Wojciech Kosmala, Dariusz Kosior, Marta Marcinkiewicz-Siemion, Barbara Brzezińska, Beata Zaborska, Marcin Fijałkowski, Iwona Świątkiewicz, Andrzej Szyszka, Jan Błażejewski, Wojciech Witkiewicz, Zbigniew Gąsior, Danuta Sorysz, Agnieszka Olszanecka
BACKGROUND: Stress echocardiography (SE) is widely used in Europe. No collective data have been available on the use of SE in Poland until now. AIM: To evaluate the number of SE investigations performed in Poland, their settings, complications and results. METHODS: In this retrospective survey, referral cardiology centers in Poland were asked to fill in a questionnaire regarding SE examinations performed from May 01, 2014 to May 01, 2015. RESULTS: The study included data from 17 university hospitals and large community hospitals which performed 4611 SE examinations, including 4408 tests in patients investigated for coronary artery disease (CAD) and 203 tests to evaluate valvular heart disease (VHD)...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28698585/effects-of-aortic-valve-replacement-on-severe-aortic-stenosis-and-preserved-systolic-function-systematic-review-and-network-meta-analysis
#3
Qishi Zheng, Andie H Djohan, Enghow Lim, Zee Pin Ding, Lieng H Ling, Luming Shi, Edwin Shih-Yen Chan, Calvin Woon Loong Chin
The survival benefits of aortic valve replacement (AVR) in the different flow-gradient states of severe aortic stenosis (AS) is not known. A comprehensive search in PubMed/MEDLINE, Embase, Cochrane Library, CNKI and OpenGrey were conducted to identify studies that investigated the prognosis of severe AS (effective orifice area ≤1.0 cm(2)) and left ventricular ejection fraction ≥50%. Severe AS was stratified by mean pressure gradient [threshold of 40 mmHg; high-gradient (HG) and low-gradient (LG)] and stroke volume index [threshold of 35 ml/m(2); normal-flow (NL) and low-flow (LF)]...
July 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28687561/impact-of-vascular-hemodynamics-on-aortic-stenosis-evaluation-new-insights-into-the-pathophysiology-of-normal-flow-small-aortic-valve-area-low-gradient-pattern
#4
Nancy Côté, Louis Simard, Anne-Sophie Zenses, Lionel Tastet, Mylène Shen, Marine Clisson, Marie-Annick Clavel
BACKGROUND: About 50% of normal-flow/low-gradient patients (ie, low mean gradient [MG] or peak aortic jet velocity and small aortic valve area) have severe aortic valve calcification as measured by computed tomography. However, they are considered to have moderate aortic stenosis (AS) in current American College of Cardiology/American Heart Association guidelines. The objective was thus to evaluate the effect of hypertension and reduced arterial compliance (rAC) on MG and Vpeak measurements...
July 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28684437/the-role-and-clinical-implications-of-diastolic-dysfunction-in-aortic-stenosis
#5
REVIEW
Polydoros N Kampaktsis, Damianos G Kokkinidis, Shing-Chiu Wong, Manolis Vavuranakis, Nikolaos J Skubas, Richard B Devereux
Diastolic dysfunction in aortic stenosis results primarily from left ventricular hypertrophy and myocardial fibrosis due to chronically elevated left ventricular systolic pressure. Currently, diastolic dysfunction does not have an explicit clinical role in management of patients with aortic stenosis. Studies have shown that improvement in diastolic dysfunction follows left ventricular remodelling after aortic valve replacement and that it occurs gradually or incompletely. Retrospective studies suggest that advanced grades of diastolic dysfunction at baseline are associated with increased mortality and adverse events even after aortic valve replacement...
July 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28599829/noninvasive-coronary-flow-reserve-predicts-response-to-exercise-in-asymptomatic-severe-aortic-stenosis
#6
Patrick Meimoun, Daniel Czitrom, Jérome Clerc, Jean Christophe Seghezzi, Sonia Martis, Alain Berrebi, Frederic Elmkies
BACKGROUND: In patients with asymptomatic aortic stenosis (AS), exercise stress echocardiography (ESE) provides additional prognostic information beyond baseline. The coronary flow velocity reserve (CFVR) is impaired in AS, but its link with exertion is unknown in this setting. The aim of this study was to test the hypothesis that CFVR could predict exercise capacity and abnormal exercise test results in AS. METHODS: Noninvasive CFVR and symptom-limited semisupine ESE were prospectively performed the same day in 43 patients with asymptomatic isolated severe AS (mean age, 68...
June 6, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28597027/-low-flow-low-gradient-aortic-valve-stenosis-current-evidence
#7
F Tillwich, M A Sherif, S Yücel, A Öner, H Ince
Many patients with severe aortic stenosis have a "low-flow, low-gradient" aortic stenosis. The management of these patients can be quite difficult, as these patients often show impairment of the left ventricle, which can lead to false measurements of the severity of stenosis and also leads to a higher risk during aortic valve replacement. More diagnostic tools than only standard echocardiography are needed to correctly differentiate true severe aortic stenosis from pseudo severe aortic stenosis.
June 9, 2017: Herz
https://www.readbyqxmd.com/read/28552098/cardiopulmonary-exercise-testing-in-aortic-stenosis
#8
Van Doan Tuyet Le
Patients with moderate to severe aortic stenosis (AVA <1.3 cm(2)) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. The mean age was 72 years and 90% of the patients had an AVA-index <0.6 cm(2)/m(2). By clinical evaluation in the outpatient clinic, 48% were judged as having functional limitation corresponding to NYHA≥II...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#9
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28528156/prognostic-impact-of-low-flow-severe-aortic-stenosis-in-small-body-patients-undergoing-tavr-the-ocean-tavi-registry
#10
Akihisa Kataoka, Yusuke Watanabe, Ken Kozuma, Yugo Nara, Fukuko Nagura, Hideyuki Kawashima, Hirofumi Hioki, Makoto Nakashima, Masanori Yamamoto, Kensuke Takagi, Motoharu Araki, Norio Tada, Shinichi Shirai, Futoshi Yamanaka, Kentaro Hayashida
OBJECTIVES: This study aimed to analyze the prognostic impact of low-flow (LF) severe aortic stenosis in small-body patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Western literature demonstrates a poor prognosis with paradoxical LF and low-flow low-gradient (LF-LG) severe aortic stenosis (AS), as defined by stroke volume index (SVi) <35 ml/m(2) and mean pressure gradient <40 mm Hg with preserved left ventricular ejection fraction (LVEF)...
May 11, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28462903/long-term-outcomes-after-tavi-in-patients-with-different-types-of-aortic-stenosis-the-conundrum-of-low-flow-low-gradient-and-low-ejection-fraction
#11
Miriam Puls, Kerstin Pia Korte, Annalen Bleckmann, Mark Huenlich, Bernhard C Danner, Friedrich Schoendube, Gerd Hasenfuß, Claudius Jacobshagen, Wolfgang Schillinger
AIMS: The objective of this study was to examine the impact of guideline-defined subtypes of severe aortic stenosis (AS) on long-term outcomes after TAVI. METHODS AND RESULTS: Four hundred (400) consecutive patients who underwent TAVI (203 transapical, 197 transfemoral) at our institution 8/2008-3/2013 were followed systematically (for up to seven years). One hundred and forty-seven (147) individuals suffered from NEF-HG AS (LV-EF ≥50%, high Pmean ≥40 mmHg), 63 from LEF-HG AS (LV-EF <50%, high gradient), 77 from PLF-LG AS (LV-EF ≥50%, low gradient, stroke volume index [SVI] <35 ml/m²), and 81 from LEF-LG AS (LV-EF <50%, low gradient)...
June 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28449976/erratum-to-diagnosis-of-paradoxical-low-flow-low-gradient-aortic-stenosis-a-complex-process-arch-cardiovasc-dis-2017-135-8
#12
Christophe Tribouilloy, Dan Rusinaru
No abstract text is available yet for this article.
April 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28444455/prevalence-predictors-and-prognostic-implications-of-residual-impairment-of-functional-capacity-after-transcatheter-aortic-valve-implantation
#13
Mohammad Abdelghani, Rafael Cavalcante, Yosuke Miyazaki, Robbert J de Winter, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
BACKGROUND: Patients with degenerative aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) typically have advanced cardiac and vascular adverse remodeling and multiple comorbidities and, therefore, might not recover a normal functional capacity after valve replacement. We sought to investigate the prevalence, the predictors, and the prognostic impact of residual impairment of functional capacity after TAVI. METHODS AND RESULTS: Out of 790 patients undergoing TAVI with impaired functional capacity (NYHA II-IV) at baseline, NYHA functional class improved in 592 (86...
April 25, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28431738/aortic-valve-replacement-in-low-flow-low-gradient-aortic-stenosis-left-ventricular-ejection-fraction-matters
#14
EDITORIAL
Victor Dayan, Philippe Pibarot
No abstract text is available yet for this article.
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28412115/outcome-of-isolated-aortic-valve-replacement-in-patients-with-classic-and-paradoxical-low-flow-low-gradient-aortic-stenosis
#15
Ana Lopez-Marco, Harriet Miller, Pankaj Kumar, Saeed Ashraf, Afzal Zaidi, Farah Bhatti, Adrian Ionescu, Aprim Youhana
OBJECTIVE: To analyze operative outcomes and mid-term results after isolated aortic valve replacement (AVR) in low-flow, low-gradient aortic stenosis (LFLG AS) by comparing the 2 subcategories (classic low-flow, low-gradient aortic stenosis [CLFLG] and paradoxical low-flow, low-gradient aortic stenosis [PLFLG]). METHODS: This was a retrospective analysis of prospectively collected data for all isolated AVR in LFLG AS performed in our center during the last 13 years (n = 198; CLFLG AS, n = 66, 33% and PLFLG AS, n = 132, 67%)...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28395281/the-role-of-stress-echocardiography-in-valvular-heart-disease-a-current-appraisal
#16
James L Gentry Iii, Dermot Phelan, Milind Y Desai, Brian P Griffin
Stress echocardiography is a widely available, safe, low-cost, versatile imaging modality which is becoming increasingly recognized as a valuable tool in the assessment of patients with native and prosthetic left-sided valvular heart disease. It provides a quantitative assessment to help guide clinical decision-making when discordance exists between symptoms and severity of valve disease. Exercise (treadmill or bicycle) remains the preferred stress modality, but pharmacological augmentation with dobutamine can be used if needed...
2017: Cardiology
https://www.readbyqxmd.com/read/28390678/effect-of-renin-angiotensin-blockers-on-left-ventricular-remodeling-in-severe-aortic-stenosis
#17
Serene Si-Ning Goh, Ching-Hui Sia, Nicholas Jinghao Ngiam, Benjamin Yong-Qiang Tan, Poay Sian Lee, Edgar Lik-Wui Tay, William Kok-Fai Kong, Tiong Cheng Yeo, Kian-Keong Poh
Studies have shown that medical therapy with renin-angiotensin blockers (RABs) may benefit patients with aortic stenosis (AS). However, its use and efficacy remains controversial, including in patients with low flow (LF) with preserved left ventricular ejection fraction (LVEF). We examined the effects of RAB use on LV remodeling in patients with severe AS with preserved LVEF, analyzing the differential effects in patients with LF compared with normal flow (NF). This is a retrospective study of 428 consecutive subjects from 2005 to 2014 with echocardiographic diagnosis of severe AS and preserved LVEF...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28385280/recommendations-on-the-echocardiographic-assessment-of-aortic-valve-stenosis-a-focused-update-from-the-european-association-of-cardiovascular-imaging-and-the-american-society-of-echocardiography
#18
Helmut Baumgartner, Judy Hung, Javier Bermejo, John B Chambers, Thor Edvardsen, Steven Goldstein, Patrizio Lancellotti, Melissa LeFevre, Fletcher Miller, Catherine M Otto
Echocardiography is the key tool for the diagnosis and evaluation of aortic stenosis. Because clinical decision-making is based on the echocardiographic assessment of its severity, it is essential that standards are adopted to maintain accuracy and consistency across echocardiographic laboratories. Detailed recommendations for the echocardiographic assessment of valve stenosis were published by the European Association of Echocardiography and the American Society of Echocardiography in 2009. In the meantime, numerous new studies on aortic stenosis have been published with particular new insights into the difficult subgroup of low gradient aortic stenosis making an update of recommendations necessary...
April 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28363204/recommendations-on-the-echocardiographic-assessment-of-aortic-valve-stenosis-a-focused-update-from-the-european-association-of-cardiovascular-imaging-and-the-american-society-of-echocardiography
#19
Helmut Baumgartner, Judy Hung, Javier Bermejo, John B Chambers, Thor Edvardsen, Steven Goldstein, Patrizio Lancellotti, Melissa LeFevre, Fletcher Miller, Catherine M Otto
Echocardiography is the key tool for the diagnosis and evaluation of aortic stenosis. Because clinical decision-making is based on the echocardiographic assessment of its severity, it is essential that standards are adopted to maintain accuracy and consistency across echocardiographic laboratories. Detailed recommendations for the echocardiographic assessment of valve stenosis were published by the European Association of Echocardiography and the American Society of Echocardiography in 2009. In the meantime, numerous new studies on aortic stenosis have been published with particular new insights into the difficult subgroup of low gradient aortic stenosis making an update of recommendations necessary...
March 1, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28345156/evolving-new-concepts-in-the-assessment-of-aortic-stenosis
#20
REVIEW
Peerawut Deeprasertkul, Masood Ahmad
Echocardiography has been pivotal in evaluating aortic stenosis (AS) over the past several decades. Recent experience has shown a wide spectrum in the clinical presentation of AS. A better understanding of the underlying hemodynamic principles has resulted in emergence of new subtypes of AS. New treatment modalities have also been introduced, requiring precise evaluation of aortic valve (AV) pathology for implementation of these therapies. This review will discuss new concepts and indices in the use of echocardiography in patients with AS...
May 2017: Echocardiography
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