Heart 2008;94:1526-1527
EDITORIALS
Assessment and management of low-gradient, low ejection fraction aortic stenosis
Inserm, ERI 12, Amiens, France and University Hospital Amiens, France
Professor C Tribouilloy, Department of Cardiovascular Disease, Avenue René Laënnec, 80054, Amiens Cedex 1, France; tribouilloy.christophe@chu-amiens.fr
| The first 150 words of the full text of this article appear below. |
Low-gradient, low ejection fraction aortic stenosis (AS) represents about 5–10% of all cases of severe AS and is the most challenging subgroup of patients to manage.1 2 The term low-gradient, low ejection fraction AS is usually applied to patients with a mean gradient <30 mm Hg (or 40 mm Hg), an aortic valve area (AVA) <1 cm2, and an ejection fraction (EF) <35% (or 40%).1–7 Low EF in such patients may be caused by severe low-flow AS with inadequate compensatory left ventricular hypertrophy, called afterload mismatch, but also by another myocardial disease (such as extensive fibrosis, associated cardiomyopathy or myocardial infarction (MI)),5 in which case, AS is not the primary problem. The essential difficulty for clinicians is to distinguish true severe low-flow AS, responsible for low EF, from pseudo-severe AS comprising mild-to-moderate AS associated with another cause of left ventricular dysfunction (LVD). A very low gradient may be seen in
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Heart 2008 94: 1627-1633.[Abstract] [Full Text] [PDF]
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