Valvular Heart DiseasePrognostic Significance of Atrial Fibrillation and Severity of Symptoms of Heart Failure in Patients With Low Gradient Aortic Stenosis and Preserved Left Ventricular Ejection Fraction
Section snippets
Methods
We analyzed our database to evaluate clinical, echocardiographic, and biohumoral data from patients with LG AS despite normal LVEF observed in our department from January 2005 to December 2010. Inclusion criteria were (1) aortic valve area (AVA; measured by the continuity equation) <1.0 cm2, (2) mean gradient (MG) ≤30 mm Hg, and (3) LVEF ≥55%. We arbitrarily decided to adopt strict enrollment criteria to minimize the burden of measurement errors. Moreover, for the same reason, the inclusion
Results
Over the considered 5-year period of analysis, within the cohort of 1,149 consecutive patients with severe AS (AVA <1 cm2) observed in the echocardiography laboratory of our department, we retrospectively identified 397 patients (35%) with LG (≤30 mm Hg); among this group, we included 167 patients (15%) with LG AS and normal LVEF (≥55%), matching the above-mentioned enrollment criteria (see Figure 1).
Complete baseline clinical and laboratory data are listed in Table 1. The median age of our
Discussion
With the present study, we proposed to carry out a comprehensive clinical and echocardiographic analysis of a large cohort of patients with LG AS despite normal LVEF, to better understand prognostic factors and therapeutic strategies in this difficult subset. The enrollment and exclusion criteria we arbitrarily decided to adopt were aimed to eliminate possible confounding factors (e.g., LVEF 50% to 54%, MG 31 to 39 mm Hg) but, at the same time, to obtain a population that is intended to be
Disclosures
The authors have no conflicts of interest to disclose.
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