Aortic Stenosis with Severely Elevated Gradients but Moderately Reduced Valve Area: What's the Prognosis?

Severe aortic stenosis (AS), most often diagnosed by transthoracic echocardiography (TTE), is generally associated with concordantly elevated mean gradients (≥40 mmHg) and severely reduced aortic valve area (AVA; ≤1 cm²). However, gradients and valve areas can be discordant — for example, in discordant low-gradient aortic stenosis (DLG-AS), where mean gradients can be relatively low (<40 mmHg) despite severely reduced AVA. In a new retrospective study, investigators focus on the other end of the spectrum, examining outcomes in patients with severely elevated mean gradients (≥40 mmHg) but more moderately reduced valve area (>1 cm²) — i.e., discordant high-gradient aortic stenosis (DHG-AS).

Investigators screened over 3500 patients presenting …