Key result
Postextrasystolic potentiation increased the transaortic gradient in a patient with low-gradient severe aortic stenosis, confirming true severity prior to successful TAVR.
Why the study?
Does postextrasystolic potentiation help identify truly severe aortic stenosis in patients with low-gradient AS and severe LV dysfunction?
Case Report (n=1)
Does postextrasystolic potentiation help identify truly severe aortic stenosis in patients with low-gradient AS and severe LV dysfunction?
Postextrasystolic potentiation may serve as a simple, non-pharmacological alternative to dobutamine stress echocardiography for confirming truly severe low-gradient aortic stenosis.
May support postextrasystolic potentiation to confirm true severe low-gradient AS; hypothesis-generating and requires prospective validation.
An elderly man with dyspnea and syncope was found to have severe aortic stenosis (AS) by the continuity equation, despite a transaortic gradient that was only moderately elevated, in the setting of severe left ventricular dysfunction. The transaortic gradient increased during postextrasystolic beats, suggesting that his that his AS was truly severe; this was confirmed by dobutamine echocardiography. He underwent transcatheter aortic-valve replacement (TAVR), with subsequent improvement in left ventricular systolic function. The diagnostic and prognostic significance of postextrasystolic potentiation, with associated increase in aortic stenosis gradient, deserves renewed attention in the TAVR era.
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Bhave et al. (2013) conducted a case report in Low-gradient severe aortic stenosis (n=1). Postextrasystolic potentiation was evaluated on Increase in transaortic gradient. Postextrasystolic potentiation increased the transaortic gradient in a patient with low-gradient severe aortic stenosis, confirming true severity prior to successful TAVR.
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