Key result
Low-gradient severe aortic stenosis with preserved ejection fraction is evaluated to determine whether it represents a distinct clinical entity or arises from discrepant diagnostic criteria.
The article highlights the diagnostic challenge of low-gradient severe aortic stenosis with preserved ejection fraction, questioning whether it is a true clinical entity or a result of discrepant guideline definitions.
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Diagnostic caution warranted for low-gradient severe AS with preserved EF; leaves open whether distinct entity or criteria artifact.
Surgery of aortic valve stenosis (AS) is often dependent on whether stenosis is considered severe, as defined by aortic valve area (AVA) and/or mean pressure gradient (dPm) criteria set forth by the American College of Cardiology/American Heart Association and the European Society of Cardiology. Problems arise in determining whether AS is severe in patients with normal left-ventricular (LV) function who meet either an AVA criterion or a dPm criterion but not the other, especially in patients with low-gradient 'severe' AS (dPm ≤ 40 mmHg, AVA < 1.0 cm2). This article considers whether low-gradient 'severe' AS with preserved ejection fraction (EF) is a new entity or merely an example of discrepant or inconsistent criteria for defining severe AS.
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Nikolaus Jander (2008) conducted a review in Low-gradient severe aortic stenosis with preserved ejection fraction. Low-gradient severe aortic stenosis with preserved ejection fraction is evaluated to determine whether it represents a distinct clinical entity or arises from discrepant diagnostic criteria.
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