Low-Gradient Severe Aortic Stenosis with Preserved Left Ventricular Function: A New Disease?

An analysis of prospective data helps to elucidate the characteristics and course of a common, clinically distinct form of AS.

Recent studies have identified a variant of severe aortic stenosis (AS) that is characterized by a low transvalvular gradient and a preserved left ventricular ejection fraction (LVEF) associated with low stroke volume. In this observational substudy of the SEAS trial, investigators compared outcomes in 435 asymptomatic patients with low-gradient severe AS (echocardiographic valve area, <1.0 cm²; mean gradient, ≤40 mm Hg) and 184 asymptomatic patients with moderate AS (valve area, 1.0–1.5 cm²; mean gradient, 25–40 mm Hg). All had LVEFs ≥55%.

The patients with low-gradient severe AS were older and had higher systolic blood pressures and lower body-mass indexes than those with moderate AS, and more of them were women. At a mean follow-up of alm…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI