Valvular & structural heart diseaseCohort study
Prevalence and Outcomes of Patients With Discordant High-Gradient Aortic Stenosis
- Retrospective cohort study
- single-centre
- tertiary referral center
- consecutive patients
Authors' conclusion
DHG-AS is not uncommon. Whereas AVA >1.0 cm2 is often seen as moderate aortic stenosis, a high-pressure gradient conveys a poor prognosis, whatever the AVA and the severity of concomitant aortic regurgitation.
Study context
- Population
- Adults with AVA ≤1.5 cm² and peak aortic jet velocity ≥2.5 m/s or mean gradient ≥25 mm Hg at an echocardiography laboratory, 2005–2015
- Participants
- 3,547 adults
- Exposure
- DHG-AS vs concordant severe, discordant low-gradient and concordant moderate AS
- DHG-ASn = 163
- Outcome
- All-cause mortality
- Follow-up
- During
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
DHG-AS vs Concordant severe ASsimilar mortality
0.98(0.66–1.44)
P = 0.91DHG-AS vs Discordant low-gradient ASsimilar mortality
0.85(0.58–1.26)
P = 0.42DHG-AS vs Concordant moderate ASmortality higher with DHG-AS
0.54(0.36–0.81)
P = 0.003Observational data: associations, not effects.
Further findings
- Prevalence of DHG-AS
- 11.6% · 163 of 163
Aortic regurgitation and survival
- After adjustment for aortic velocities, aortic regurgitation had no significant impact on survival
Aortic valve calcium score
- Aortic valve calcium (AVC) in DHG-AS higher than concordant moderate AS and discordant low-gradient AS; not significantly different from concordant severe AS
Original publication
Prevalence and Outcomes of Patients With Discordant High-Gradient Aortic Stenosis. J Am Coll Cardiol. Published 26 March 2024. doi:10.1016/j.jacc.2024.01.025
Summarised from the published abstract; every number is checked against it