Related Experiment Video
Updated: Jun 4, 2026

O-Ring Aortic Banding Versus Traditional Transverse Aortic Constriction for Modeling Pressure Overload-Induced Cardiac Hypertrophy
Published on: October 6, 2022
Frequency, characteristics, and outcome of patients with aortic stenosis, left ventricular dysfunction, and high
Diab Mutlak1, Doron Aronson, Jonathan Lessick
1Echocardiography Laboratory and Heart Valves Clinic, Department of Cardiology, Rambam Health Care Campus, affiliated with Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel.
Background:
Trans-aortic pressure gradient in patients with aortic stenosis and left ventricular systolic dysfunction is typically low but occasionally high.
Objectives:
To examine the distribution of trans-aortic PG in patients with severe AS and severe LV dysfunction and compare the clinical and echocardiographic characteristics and outcome of patients with high versus low PG.
Methods:
Using the echocardiographic laboratory database at our institution, 72 patients with severe AS (aortic valve area < or = 1.0 cm2) and severe LV dysfunction (LV ejection fraction < or = 30%) were identified. The characteristics and outcome of these patients were compared.
Results:
PG was high (mean PG > or = 35 mmHg) in 32 patients (44.4%) and low (< 35 mmHg) in 40 (55.6%). Aortic valve area was slightly smaller in patients with high PG (0.63 + 0.15 vs. 0.75 +/- 0.16 cm2 in patients with low PG, P = 0.003), and LV ejection fraction was slightly higher in patients with high PG (26 +/- 5 vs. 22 +/- 5% in patients with low PG, P = 0.005). During a median follow-up period of 9 months 14 patients (19%) underwent aortic valve replacement and 46 patients (64%) died. Aortic valve replacement was associated with lower mortality (age and gender-adjusted hazard ratio 0.19, 95% confidence interval 0.05-0.82), whereas trans-aortic PG was not (P = 0.41).
Conclusions:
A large proportion of patients with severe AS have relatively high trans-aortic PG despite severe LV dysfunction, a finding partially related to more severe AS and better LV function. Trans-aortic PG is not related to outcome in these patients.
Related Concept Videos
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic Regurgitation I: Introduction
Aortic Regurgitation III: Medical Management
Aortic Regurgitation IV: Nursing Management
Mitral Stenosis I: Introduction
Mitral Stenosis II: Clinical features and Diagnostic Tests

