Classification of aortic stenosis by flow and gradient patterns provides insights into the pathophysiology of disease

Bhattacharyya, S., Mittal, T., Abayalingam, M., Kabir, T., Dalby, M., Cleland, J. G.F. , Baltabaeva, A. and Rahman Haley, S. (2016) Classification of aortic stenosis by flow and gradient patterns provides insights into the pathophysiology of disease. Angiology, 67(7), pp. 664-669. (doi:10.1177/0003319715611804) (PMID:26475710)

[img]
Preview
Text
128388.pdf - Accepted Version

197kB

Abstract

Different patterns of flow and valve gradients can lead to diagnostic uncertainty about the severity of aortic stenosis (AS). Consecutive patients with severe AS (valve area <1 cm2) underwent echocardiography and computed tomography. Patients were classified into 4 groups (high-gradient/normal flow [HGNF], high-gradient/low flow [HGLF], low-gradient/normal flow [LGNF], and low-gradient/low flow [LGLF]). Low flow was defined as stroke volume index <35 mL/m2 and low gradient as a mean aortic gradient <40 mm Hg. Aortic valve calcification (AVC) was calculated using the Agatston score. Of 181 patients, 56, 30, 46, and 49 had HGNF, HGLF, LGNF and LGLF with median AVC of 2048, 2015, 1366, and 1178 AU/m2 (P < .0001) and valvuloarterial impedance of 4.5, 6.4, 4.2, and 5.9, respectively (P < .0001). Among those with LGLF, AVC was lower in patients with preserved compared to reduced left ventricular ejection fraction (1018 vs 2550 AU/m2; P < .0001), but valvuloarterial impedance was similar (P = .33). The LGLFAS with preserved ejection fraction is associated with lower AVC and may identify patients with less severe AS in association with an adaptive ventricular response to high afterload.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Bhattacharyya, S., Mittal, T., Abayalingam, M., Kabir, T., Dalby, M., Cleland, J. G.F., Baltabaeva, A., and Rahman Haley, S.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Angiology
Publisher:SAGE Publications
ISSN:0003-3197
ISSN (Online):1940-1574
Published Online:15 October 2015
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Angiology 67(7): 664-669
Publisher Policy:Reproduced in accordance with the publisher copyright policy

University Staff: Request a correction | Enlighten Editors: Update this record