{"id":5795,"date":"2011-02-16T06:03:55","date_gmt":"2011-02-16T00:33:55","guid":{"rendered":"http:\/\/cardiophile.org\/?p=5795"},"modified":"2011-02-16T06:03:55","modified_gmt":"2011-02-16T00:33:55","slug":"severe-aortic-stenosis-with-low-trans-valvar-gradient","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/severe-aortic-stenosis-with-low-trans-valvar-gradient\/","title":{"rendered":"Severe aortic stenosis with low transvalvar gradient"},"content":{"rendered":"

Severe aortic stenosis with low transvalvar gradient<\/span><\/h2>\n

Usually severe aortic stenosis is associated with a high transvalvar gradient. But the gradient can be falsely low in the presence of severe left ventricular systolic dysfunction which prevents the development of high gradient. There is also a subset of severe aortic stenosis with low gradient (defined as aortic valve area less than 1 square centimeter and mean gradient of 40 mm Hg or less) and normal ejection fraction. A study by Nikolaus Jander, Jan Minners, Ingar Holme, Eva Gerdts, Kurt Boman, Philippe Brudi, John B Chambers, Kenneth Egstrup, Y Antero Kes\u00e4niemi, William Malbecq, Christoph A Nienaber, Simon Ray, Anne Rosseb\u00f8, Terje R Pedersen, Terje Skj\u00e6rpe, Ronnie Willenheimer, Kristian Wachtell, Franz-Josef Neumann and Christa Gohlke-B\u00e4rwolf [1] compared this type of patients with those with moderate aortic stenosis (aortic valve area between 1 square centimeter and 1.5 square centimeter with a mean gradient between 25 and 40 mm Hg). They found that patients with low gradient severe aortic stenosis and a normal ejection fraction have comparable cardiac events and cardiovascular mortality to those with moderate aortic stenosis. This was a substudy of the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial which had enrolled 1873 patients with asymptomatic aortic stenosis. The SEAS had no difference in major cardiovascular events between treatment and placebo groups, but had a significant reduction in ischemic events in patients treated with ezetimibe\/simvastatin [2].<\/p>\n

Reference<\/span><\/strong><\/p>\n

    \n
  1. Nikolaus Jander, Jan Minners, Ingar Holme, Eva Gerdts, Kurt Boman, Philippe Brudi, John B Chambers, Kenneth Egstrup, Y Antero Kes\u00e4niemi, William Malbecq, Christoph A Nienaber, Simon Ray, Anne Rosseb\u00f8, Terje R Pedersen, Terje Skj\u00e6rpe, Ronnie Willenheimer, Kristian Wachtell, Franz-Josef Neumann, Christa Gohlke-B\u00e4rwolf. Outcome of patients with low-gradient “severe” aortic stenosis and preserved ejection fraction<\/a>. Circulation. 2011 Mar 1;123(8):887-95.<\/li>\n
  2. Anne B Rosseb\u00f8, Terje R Pedersen, Kurt Boman, Philippe Brudi, John B Chambers, Kenneth Egstrup, Eva Gerdts, Christa Gohlke-B\u00e4rwolf, Ingar Holme, Y Antero Kes\u00e4niemi, William Malbecq, Christoph A Nienaber, Simon Ray, Terje Skjaerpe, Kristian Wachtell, Ronnie Willenheimer, SEAS Investigators. Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis<\/a>. N Engl J Med. 2008 Sep 25;359(13):1343-56.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Severe aortic stenosis with low trans valvar gradient could be due to LV dysfunction or a specific subset with normal ejection fraction.<\/p>\n","protected":false},"author":1,"featured_media":36579,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-5795","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"\nSevere aortic stenosis with low transvalvar gradient<\/title>\n<meta name=\"description\" content=\"Severe aortic stenosis with low transvalvar gradient could be due to LV dysfunction or a specific subset with normal ejection fraction.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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