Document Detail

Low-flow, low-gradient, normal ejection fraction aortic stenosis.
MedLine Citation:
PMID:  20425164     Owner:  NLM     Status:  In-Process    
A substantial proportion of patients with severe aortic stenosis may paradoxically have low transvalvular flow and a low gradient, despite the presence of normal left ventricular (LV) ejection fraction. These patients are characterized by pronounced LV concentric remodeling with small LV cavity size, impaired LV filling, altered myocardial function, and worse prognosis. This frequent clinical entity is often misdiagnosed, which may lead to an underestimation of aortic stenosis severity and thereby to underutilization or inappropriate delay of surgery. It is important to recognize this entity so we do not deny surgery to a symptomatic patient with small aortic valve area and low gradient. Thus, when there is a discordance between the valve area (in the severe range) and the gradient (in the moderate range) in patients with preserved LV ejection fraction, a more comprehensive Doppler echocardiographic evaluation and potentially other diagnostic tests may be required to confirm disease severity and guide therapeutic management.
Philippe Pibarot; Jean G Dumesnil
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current cardiology reports     Volume:  12     ISSN:  1534-3170     ISO Abbreviation:  Curr Cardiol Rep     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888969     Medline TA:  Curr Cardiol Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  108-15     Citation Subset:  IM    
Institut Universitaire de Cardiologie et de Pneumologie de Québec, Canada.
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MeSH Terms
Grant Support
MOP 57445//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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