Valvular & structural heart disease
Low-Gradient Severe Aortic Stenosis: Insights From the CURRENT Aortic Stenosis (AS) Registry-2
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 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: Insights From the CURRENT AS Registry-2. JACC Cardiovasc Interv. Published 18 December 2024. doi:10.
Summarised from the published abstract; every number is checked against it