Stress echocardiography to assess stenosis severity and predict outcome in patients with paradoxical low-flow, low-gradient aortic stenosis and preserved LVEF.
Marie-Annick Clavel,Pierre Vladimir Ennezat,Sylvestre Maréchaux,Jean G. Dumesnil,Romain Capoulade,Zeineb Hachicha,Patrick Mathieu,Annaïk Bellouin,Sébastien Bergeron,Patrick Meimoun,Marie Arsenault,Thierry Le Tourneau,Agnes Pasquet,Christian Couture,Philippe Pibarot +14 more
Reads0
Chats0
TLDR
In patients with PLFLG AS, the measurement of AVA(proj) derived from stress echocardiography is helpful to determine the actual severity of the stenosis and predict risk of adverse events.Abstract:
The objective of this study was to examine the value of stress-echocardiography in patients with paradoxical low-flow, low-gradient (PLFLG) aortic stenosis (AS). The projected aortic valve area (AVAProj) at a normal flow rate was calculated in 55 patients with PLFLG AS. In the subset of patients (n = 13) who underwent an aortic valve replacement within 3 months after stress echocardiography, AVA(Proj) correlated better with the valve weight compared to traditional resting and stress echocardiographic parameters of AS severity (AVA(Proj): r = -0.78 vs. other parameters: r = 0.46 to 0.56). In the whole group (N = 55), 18 (33%) patients had an AVA(Proj) >1.0 cm(2), being consistent with the presence of pseudo severe AS. The AVA(Proj) was also superior to traditional parameters of stenosis severity for predicting outcomes (hazard ratio: 1.32/0.1 cm(2) decrease in AVA(Proj)). In patients with PLFLG AS, the measurement of AVA(proj) derived from stress echocardiography is helpful to determine the actual severity of the stenosis and predict risk of adverse events.read more
Citations
More filters
Journal ArticleDOI
Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography
Helmut Baumgartner,Judy Hung,Javier Bermejo,John B. Chambers,Thor Edvardsen,Steven A. Goldstein,Patrizio Lancellotti,Melissa LeFevre,Fletcher A. Miller,Catherine M Otto +9 more
TL;DR: This document focuses in particular on the optimization of left ventricular outflow tract assessment, low flow, low gradient aortic stenosis with preserved ejection fraction, and a grading algorithm for an integrated and stepwise approach of aorti stenosis assessment in clinical practice.
Journal ArticleDOI
Calcific aortic stenosis.
Brian R. Lindman,Marie-Annick Clavel,Patrick Mathieu,Bernard Iung,Patrizio Lancellotti,Catherine M Otto,Philippe Pibarot +6 more
TL;DR: The introduction of transcatheter AVR in the past decade has been a transformative therapeutic innovation for patients at high or prohibitive risk for surgical valve replacement, and this new technology might extend to lower-risk patients in the near future.
Journal ArticleDOI
The Role of Stress Echocardiography in Valvular Heart Disease: A Current Appraisal
TL;DR: Stress echocardiography not only identifies high-risk features that indicate need for earlier surgery, it also provides useful information for the peri- and postoperative period, including long-term outcome, risk stratification to guide monitoring frequency, and offers guidance for eligibility in competitive sports participation.
Journal ArticleDOI
The Complex Nature of Discordant Severe Calcified Aortic Valve Disease Grading : New Insights From Combined Doppler Echocardiographic and Computed Tomographic Study
Marie-Annick Clavel,David Messika-Zeitoun,Philippe Pibarot,Shivani R. Aggarwal,Joseph Malouf,Phillip A. Araoz,Hector I. Michelena,Caroline Cueff,Eric Larose,Romain Capoulade,Alec Vahanian,Maurice Enriquez-Sarano +11 more
TL;DR: The clinical yield of AVC quantification by MDCT to diagnose and manage these complex patients is emphasized, with at least one-half of the patients with discordant low gradient present with heavy AVC-load reflective of severe calcified aortic valve disease.
Journal ArticleDOI
Impact of Aortic Valve Calcification, as Measured by MDCT, on Survival in Patients With Aortic Stenosis: Results of an International Registry Study
Marie-Annick Clavel,Philippe Pibarot,David Messika-Zeitoun,Romain Capoulade,Joseph Malouf,Shivani Aggarval,Phillip A. Araoz,Hector I. Michelena,Caroline Cueff,Eric Larose,Jordan D. Miller,Alec Vahanian,Maurice Enriquez-Sarano +12 more
TL;DR: This large-scale, multicenter outcomes study of quantitative Doppler echocardiographic and multidetector computed tomography assessment of AS shows that measuring AVC load provides incremental prognostic value for survival beyond clinical and Dopplers echOCardiographic assessment.
References
More filters
Journal ArticleDOI
Guidelines on the management of valvular heart disease The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Alec Vahanian,Helmut Baumgartner,Jeroen J. Bax,Butchart Eg,Robert Dion,Gerasimos Filippatos,Frank A. Flachskampf,Roger Hall,Bernard Iung,Jarosław D. Kasprzak,Patrick Nataf,Pilar Tornos,Lucia Torracca,Arnold Wenink,Silvia G. Priori,Jean-Jacques Blanc,Andrzej Budaj,John Camm,Veronica Dean,Jaap W. Deckers,Kenneth Dickstein,John Lekakis,Keith McGregor,Marco Metra,João Morais,Ady Osterspey,Juan Tamargo,José Luis Zamorano,Annalisa Angelini,Manuel J. Antunes,Miguel Ángel García Fernández,Christa Gohlke-Baerwolf,Gilbert Habib,John J.V. McMurray,Catherine M Otto,Luc Pierard,José L. Pomar,Bernard Prendergast,Raphael Rosenhek,Miguel Sousa Uva +39 more
TL;DR: Guidelines and Expert Consensus Documents aim to present management recommendations based on all of the relevant evidence on a particular subject in order to help physicians select the best possible management strategies for the individual patient suffering from a specific condition, taking into account the impact on outcome and also the risk–benefit ratio of a particular diagnostic or therapeutic procedure.
Journal ArticleDOI
Guidelines on the management of valvular heart disease (version 2012)
Alec Vahanian,Ottavio Alfieri,Felicita Andreotti,Manuel J. Antunes,Gonzalo Barón-Esquivias,Helmut Baumgartner,Michael A. Borger,Thierry Carrel,Michele De Bonis,Arturo Evangelista,Volkmar Falk,Bernard Iung,Patrizio Lancellotti,Luc Pierard,Susanna Price,Hans-Joachim Schäfers,Gerhard Schuler,Janina Stępińska,Karl Swedberg,Johanna J.M. Takkenberg,Ulrich O. von Oppell,Stephan Windecker,José Luis Zamorano,Marian Zembala +23 more
TL;DR: Guidelines summarize and evaluate all evidence available on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome.
Journal ArticleDOI
Guidelines on the management of valvular heart disease (version 2012)The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)
Journal ArticleDOI
Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis Despite Preserved Ejection Fraction Is Associated With Higher Afterload and Reduced Survival
TL;DR: A comprehensive evaluation of the clinical and Doppler echocardiographic data of 512 consecutive patients with severe aortic stenosis shows that this pattern is in fact consistent with a more advanced stage of the disease and has a poorer prognosis.
Journal ArticleDOI
Measurement of aortic valve calcification using multislice computed tomography: Correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction
Caroline Cueff,Jean Michel Serfaty,Claire Cimadevilla,Jean Pierre Laissy,Dominique Himbert,Florence Tubach,Xavier Duval,Bernard Iung,Maurice Enriquez-Sarano,Alec Vahanian,David Messika-Zeitoun +10 more
TL;DR: In this large series of patients with a wide range of AS, AVC was shown to be well correlated to AVA and may be a useful adjunct for the evaluation of AS severity especially in difficult cases such as patients with low EF.
Related Papers (5)
Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis Despite Preserved Ejection Fraction Is Associated With Higher Afterload and Reduced Survival
Guidelines on the management of valvular heart disease (version 2012)
Alec Vahanian,Ottavio Alfieri,Felicita Andreotti,Manuel J. Antunes,Gonzalo Barón-Esquivias,Helmut Baumgartner,Michael A. Borger,Thierry Carrel,Michele De Bonis,Arturo Evangelista,Volkmar Falk,Bernard Iung,Patrizio Lancellotti,Luc Pierard,Susanna Price,Hans-Joachim Schäfers,Gerhard Schuler,Janina Stępińska,Karl Swedberg,Johanna J.M. Takkenberg,Ulrich O. von Oppell,Stephan Windecker,José Luis Zamorano,Marian Zembala +23 more