Valvular & structural heart diseaseCohort study
Low-Gradient Severe Aortic Stenosis
- Registry-based cohort study
Authors' conclusion
Clinical outcomes were significantly worse in LG AS with reduced LVEF and paradoxical LFLG AS and comparable in NFLG AS compared with HG AS.
Study context
- Population
- Patients with severe aortic stenosis (AS) in the CURRENT AS Registry-2 with indexed stroke volume and left ventricular ejection fraction (LVEF) data
- Participants
- 3,363 patients
- Exposure
- Hemodynamic types of low-gradient AS vs high-gradient AS
- Low-gradient (LG) AS with reduced LVEFn = 285
- Paradoxical LFLGn = 220
- NFLGn = 872
- High-gradient (HG)n = 1,986reference
- Outcome
- Death or HF hospitalization
- Follow-up
- 3 years
Main finding
As reported in the abstract
Death or HF hospitalization (adjusted)
Each group vs HGHazard ratio (95% CI)P value
LG AS with reduced LVEF
1.82(1.49–2.23)
P < 0.001Paradoxical LFLG
1.43(1.13–1.82)
P = 0.003NFLG
1.03(0.88–1.21)
P = 0.68Observational data: associations, not effects.
Further findings
Clinical characteristics vs HG AS
- LG AS with reduced LVEF: more CV comorbidities, advanced cardiac damage and frailty, less severe valve calcification
- Paradoxical LFLG: more AF, advanced cardiac damage and frailty, less severe valve calcification
- NFLG: comparable cardiac damage and frailty, less severe valve calcification
Original publication
Low-Gradient Severe Aortic Stenosis. JACC Cardiovasc Interv. Published 18 December 2024. doi:10.1016/j.jcin.2024.09.044
Summarised from the published abstract; every number is checked against it