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Low–flow severe aortic stenosis (AS) is a controversial entity and has recently been described in the West. We aim to compare selected clinical and echocardiographic characteristics between low–flow (LF) and normal–flow (NF) severe AS with preserved ejection fraction (LVEF) in Asian subjects.
We studied 521 consecutive patients with severe AS (indexed aortic valve area (AVAI) ≤0.6 cm2.m–2) and preserved LVEF (≥50%). LF was defined as a stroke volume index (SVI) of ≤35 mL.m–2.
There were 206 patients (40%) with LF and 315 with NF severe AS. The mean age was similar (71±14 vs. 70±14 years, p=0.222) and prevalence of females was higher (62% vs. 52%, p=0.012) in the LF group. There was no difference in prevalence of LF among the ethnicities. Systolic and diastolic blood pressures were similar between the two groups. However, resting heart rate was higher in the LF group (74±21 vs. 69±16 bpm, p=0.001). The prevalence of low mean transaortic pressure gradient (≤40 mmHg) was high in both groups: 77% and 66% in the LF and NF groups respectively (p=0.004). The table summarizes the differences in echocardiographic findings between the groups. The echocardiographic findings in the table were similar between ethnicities and gender in both the LF and NF groups.
Several clinical and echocardiographic characteristics are associated with the LF severe AS phenotype. This is likely a reflection of not only aortic valve disease but also myocardial and systemic arterial dysfunction.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Valvular Heart Disease: Clinical III – Aortic Valve Stenosis
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1155–75
- 2013 American College of Cardiology Foundation