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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorGalián Gay, Laura
dc.contributor.authorEscalona Silva, Roxana Andreina
dc.contributor.authorTeixido Tura, Gisela
dc.contributor.authorCasas Masnou, Guillem
dc.contributor.authorFerrer-Sistach, Elena
dc.contributor.authorMitroi, Cristina
dc.contributor.authorGonzález Alujas, Teresa
dc.contributor.authorGutierrez García-Moreno, Laura
dc.contributor.authorFernández Galera, Ruben
dc.contributor.authorDe Carvalho Negrao Valente, Filipa Xavier
dc.contributor.authorGuala, Andrea
dc.contributor.authorRuiz Muñoz, Aroa
dc.contributor.authorSao Aviles, Augusto Cesar
dc.contributor.authorRodríguez Palomares, Jose Fernando
dc.contributor.authorFerreira González, Ignacio
dc.contributor.authorEvangelista Masip, Artur
dc.date.accessioned2022-09-12T10:03:38Z
dc.date.available2022-09-12T10:03:38Z
dc.date.issued2022-04-01
dc.identifier.citationGalian-Gay L, Escalona Silva RA, Teixidó-Turà G, Casas G, Ferrer-Sistach E, Mitroi C, et al. Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits. Front Cardiovasc Med. 2022 Apr 1;9:852954.
dc.identifier.issn2297-055X
dc.identifier.urihttp://hdl.handle.net/11351/8157
dc.descriptionAortic stenosis; Echocardiography; Heart valve disease
dc.description.abstractObjectives: To determine the risk of mortality and need for aortic valve replacement (AVR) in patients with low-flow low-gradient (LFLG) aortic stenosis (AS). Methods: A longitudinal multicentre study including consecutive patients with severe AS (aortic valve area [AVA] < 1.0 cm2) and normal left ventricular ejection fraction (LVEF). Patients were classified as: high-gradient (HG, mean gradient ≥ 40 mmHg), normal-flow low-gradient (NFLG, mean gradient < 40 mmHg, indexed systolic volume (SVi) > 35 ml/m2) and LFLG (mean gradient < 40 mmHg, SVi ≤ 35 ml/m2). Results: Of 1,391 patients, 147 (10.5%) had LFLG, 752 (54.1%) HG, and 492 (35.4%) NFLG. Echocardiographic parameters of the LFLG group showed similar AVA to the HG group but with less severity in the dimensionless index, calcification, and hypertrophy. The HG group required AVR earlier than NFLG (p < 0.001) and LFLG (p < 0.001), with no differences between LFLG and NFLG groups (p = 0.358). Overall mortality was 27.7% (CI 95% 25.3–30.1) with no differences among groups (p = 0.319). The impact of AVR in terms of overall mortality reduction was observed the most in patients with HG (hazard ratio [HR]: 0.17; 95% CI: 0.12–0.23; p < 0.001), followed by patients with LFLG (HR: 0.25; 95% CI: 0.13–0.49; p < 0.001), and finally patients with NFLG (HR: 0.29; 95% CI: 0.20–0.44; p < 0.001), with a risk reduction of 84, 75, and 71%, respectively. Conclusions: Paradoxical LFLG AS affects 10.5% of severe AS, and has a lower need for AVR than the HG group and similar to the NFLG group, with no differences in mortality. AVR had a lower impact on LFLG AS compared with HG AS. Therefore, the findings of the present study showed LFLG AS to have an intermediate clinical risk profile between the HG and NFHG groups.
dc.language.isoeng
dc.publisherFrontiers Media
dc.relation.ispartofseriesFrontiers in Cardiovascular Medicine;9
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectVàlvula aòrtica - Estenosi - Cirurgia
dc.subjectVàlvula aòrtica - Estenosi - Prognosi
dc.subject.meshAortic Valve Stenosis
dc.subject.mesh/surgery
dc.subject.meshPrognosis
dc.titlePrognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.3389/fcvm.2022.852954
dc.subject.decsestenosis de la válvula aórtica
dc.subject.decs/cirugía
dc.subject.decspronóstico
dc.relation.publishversionhttps://doi.org/10.3389/fcvm.2022.852954
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Galian-Gay L, Escalona Silva RA, Teixidó-Turà G, Casas G, González-Alujas T, Gutiérrez L, Fernandez-Galera R, Valente F, Guala A, Ruiz-Muñoz A, Avilés CAS, Palomares JFR, Ferreira I, Evangelista A] Servei de Cardiologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. CIBER-CV, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Ferrer-Sistach E] Department of Cardiology, Hospital Universitari Germans Tries i Pujol, Badalona, Spain. [Mitroi C] Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
dc.identifier.pmid35433871
dc.identifier.wos000806264400001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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