Valvular & structural heart disease
Impact of low stroke volume on mortality in patients with severe aortic stenosis and preserved left ventricular ejection fraction
Authors' conclusion
Low flow defined as SVi < 30 mL/m2 or SV < 55 mL is an important outcome predictor in severe AS with preserved LVEF under medical and surgical management.
Study context
- Population
- Severe aortic stenosis (AS) (aortic valve area <1 cm² and/or <0.6 cm²/m²) with preserved left ventricular ejection fraction (LVEF), under medical and surgical managementplus 1645 controls
- Participants
- 1,450 participants
- Exposure
- Low stroke volume vs normal flow
- Outcome
- Mortality
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Mortality (adjusted, incl. aortic valve replacement)
Adjusted hazard ratio (CI)
SVi < 30 mL/m²vs SVi > 35 mL/m²
1.60(1.17–2.18)
SV < 55 mLvs SV > 70 mL
1.84(1.32–2.58)
SVi 30-35 mL/m²vs SVi > 35 mL/m²similar risk
1.05(0.78–1.41)
SV 55-70 mLvs SV > 70 mLsimilar risk
1.22(0.94–1.58)
Observational data: associations, not effects.
Further findings
5-year survival
- Low for stroke volume index (SVi) < 30 mL/m² and SV < 55 mL vs other groups
- all P-values <0.001
Subgroups incl. asymptomatic and low-gradient severe AS
- Prognostic impact of SVi < 30 mL/m² and SV < 55 mL consistent in subgroups
Original publication
Impact of low stroke volume on mortality in patients with severe aortic stenosis and preserved left ventricular ejection fraction. Eur Heart J. Published 13 March 2018. doi:10.
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