Likely severe discordant aortic stenosis with normal LV systolic function was associated with lower 5-year cardiac mortality after TAVI compared to unlikely severe AS (HR 0.40; 95% CI 0.17-0.95).
Observational (n=134)
No
Does invasively measured transvalvular flow rate predict likely severe aortic valve stenosis and 5-year cardiac mortality in patients with low-gradient severe AS and normal LVEF?
Invasively measured transvalvular flow rate ≤ 200 ml/s is strongly associated with likely severe AS and predicts 5-year cardiac mortality after TAVI in patients with low-gradient AS and normal LVEF.
Hazard Ratio: 0.4 (95% CI 0.17–0.95)
valor p: p=0.038
Background There are limited data on the diagnostic role of invasively measured transvalvular flow rate (TFR) in patients with low-gradient (mean gradient 35 ml/m2 had TFR ≤ 200 ml/s. Patients with likely severe AS showed lower 5-year cardiac mortality compared with unlikely severe AS after TAVI (adj. HR 0.40; 95% CI 0.17–0.95, p = 0.038), and comparable to high-gradient severe AS (21.3% vs. 26.2%, log rank, p = 0.847). TFR ≤ 200 ml/s was highly associated with the diagnosis of likely severe AS (adj. OR 3.09; 95% CI 1.30–7.34, p = 0.010). Integrating TFR into the diagnostic criteria for severe AS could predict 5-year cardiac mortality (adj. HR 0.45; 95% CI 0.21–0.97, p = 0.042), unlike SVi. Conclusion Low invasive TFR is highly associated with the diagnosis of likely severe AS. Likely severe discordant AS with normal LV systolic function showed better long-term outcome after TAVI. Graphical Abstract
Elbasha et al. (Tue,) conducted a observational in Low-gradient severe aortic valve stenosis with normal LVEF (n=134). Likely severe aortic stenosis vs. Unlikely severe aortic stenosis was evaluated on 5-year cardiac mortality (HR 0.40, 95% CI 0.17-0.95, p=0.038). Likely severe discordant aortic stenosis with normal LV systolic function was associated with lower 5-year cardiac mortality after TAVI compared to unlikely severe AS (HR 0.40; 95% CI 0.17-0.95).