Author + information
- Darae Kim,
- Chi Young Shim,
- In-Jeong Cho,
- Hyuk-Jae Chang,
- Geu-Ru Hong,
- Jong-Won Ha and
- Namsik Chung
Background: Flow-gradient patterns in severe aortic stenosis (AS) with preserved ejection fraction provides prognostic information. We compared the prevalence of four flow-gradient patterns in severe AS between bicuspid and tricuspid phenotypes.
Methods: 187 patients with severe AS (103 bicuspid vs. 84 tricuspid) who underwent surgical aortic valve (AV) replacement from 2010 to 2015 in a single center were analyzed. Patients with other significant valve dysfunction or ejection fraction<50% were excluded. Patients were classified into 4 groups according to stroke volume index (SVI, 35 ml/m2) and AV mean pressure gradient (MPG, 40 mmHg) [Normal-flow high-gradient (NFHG), Low-flow high-gradient (LFHG, Normal-flow low-gradient (NFLG), low-flow low-gradient (LFLG)].
Results: Patients with bicuspid AS were younger than those with tricuspid AS. Although averages of NT Pro-BNP and SVI did not differ between two groups, MPG was significantly higher in bicuspid AS than tricuspid AS (62±17 vs. 51±18 mmHg, p<0.01). NFHG AS, especially NF-very HG (MPG≥50 mmHg), were more prevalent in bicuspid AS, whereas none of bicuspid AS was classified as paradoxically LFLG. In multivariate analysis, increased stroke volume, relatively smaller left ventricular outflow track diameter or ascending aorta, and low systolic blood pressure independently determined the NF-very HG pattern in bicuspid AS.
Conclusions: Severe AS with bicuspid AV mostly presents with NFHG, especially NF-very HG, and paradoxical LFLG is rare.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Aortic Stenosis
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1233-029
- 2017 American College of Cardiology Foundation