Document Detail

Subvalvular gradients in patients with valvular aortic stenosis: prevalence, magnitude, and physiological importance.
MedLine Citation:
PMID:  11524395     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although subvalvular gradients in patients with aortic stenosis have been described, their behavior and response to exercise have not been well characterized. METHODS AND RESULTS: Left ventricular and aortic pressures and linear flow velocity were measured with a catheter-tip manometer at rest and during supine exercise in 27 patients with valvular aortic stenosis. A subvalvular gradient was measured in each patient that represented, on average, 48% of the total resting transvalvular gradient. With exercise, both total (rest: 80+/-26 mm Hg; exercise: 90+/-25 mm Hg) and subvalvular gradients (rest: 37+/-13 mm Hg; exercise: 60+/-22 mm Hg) increased significantly. There was a significant inverse relationship between change in exercise cardiac output and total and subvalvular gradients. However, only the exercise subvalvular gradient predicted cardiac output response. CONCLUSIONS: Subvalvular pressure gradients are universally present in patients with severe aortic stenosis and comprise approximately half of the total transvalvular gradient. The extent of exercise cardiac output increase is inversely related to the subvalvular gradient magnitude.
W K Laskey; W G Kussmaul
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  104     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-28     Completed Date:  2001-09-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1019-22     Citation Subset:  AIM; IM    
Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. wlaskey@
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MeSH Terms
Aortic Valve / physiopathology*
Aortic Valve Stenosis / physiopathology*
Cardiac Output / physiology
Exercise Test
Heart Catheterization
Heart Ventricles / physiopathology
Hemodynamics / physiology
Middle Aged

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

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