Paradoxical low-flow aortic stenosis - baseline characteristics, impact on mortality

Area of Science:

• Cardiology
• Interventional Cardiology
• Echocardiography

Background:

• Paradoxical low-flow, low-gradient aortic stenosis (pLF-LGAS) is an underdefined subtype of aortic stenosis (AS).
• pLF-LGAS represents a significant portion of patients undergoing transcatheter aortic valve implantation (TAVI).

Purpose of the Study:

• To characterize baseline features of pLF-LGAS patients.
• To evaluate the impact of pLF-LGAS on mortality following TAVI.

Main Methods:

• A retrospective analysis of 231 patients undergoing TAVI.
• Echocardiographic identification and classification of AS subtypes: pLF-LGAS, classical low-flow, low-gradient AS (cLF-LGAS), and high-gradient AS (HGAS).
• Comparison of baseline characteristics and assessment of 30-day and 1-year all-cause mortality.

Main Results:

• pLF-LGAS was identified in 18.2% of patients.
• pLF-LGAS patients were younger, had higher ejection fraction (EF), and more hypertension than HGAS patients.
• 30-day and 1-year survival rates were comparable across AS subtypes; severe renal failure independently predicted mortality.

Conclusions:

• pLF-LGAS is a frequent finding in TAVI candidates with unique demographic and clinical profiles.
• The presence of pLF-LGAS does not appear to influence short- to mid-term survival post-TAVI.
• Severe renal failure is a critical predictor of mortality in the TAVI population.