Low-flow low-gradient aortic stenosis: Prognostic impact and effect of surgery

Impact of Flow and Left Ventricular Strain on Outcome of Patients With Preserved Left Ventricular Ejection Fraction and Low Gradient Severe Aortic Stenosis Undergoing Aortic Valve Replacement

“…LV global longitudinal strain may be impaired in patients with low gradient severe AS and preserved LVEF possibly due to subendocardial ischemia, myocardial fibrosis, concentric remodelling or increased afterload. 6,16,24 LV global longitudinal strain can detect the subtle intrinsic myocardial systolic dysfunction and its impairment precedes LVEF reduction. 16,25 However, randomized studies would be preferable to confirm the benefits of AVR in this subgroup of patients and impact on current practice guidelines.…”

“…Transmitral Based on SVi patients were divided into two categories: low flow was defined as SVi≤35ml/m 2 and normal flow as SVi>35ml/m 2 . 6,13,14 Patients were also categorized as having an LV global longitudinal strain ≤-15% or >-15%. 7, [15][16][17] The end-point of the study was all-cause mortality.…”

“…Despite having preserved LVEF, these patients have impaired LV mechanics as assessed with LV global longitudinal strain speckle tracking echocardiography and may have normal or low forward flow evaluated by stroke volume index (SVi). 3,6 The influence of flow and LV global longitudinal strain on the prognosis of patients with preserved LVEF low gradient severe AS remains unexplored. The present evaluation assessed the relative merits of flow and LV global longitudinal strain to predict the outcome of patients with severe AS, low gradient and preserved LVEF who underwent AVR.…”