Related Experiment Video

Updated: Oct 29, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

1.9K

High Prevalence of Severe Aortic Stenosis in Low-Flow State Associated With Atrial Fibrillation

Said Alsidawi1,2, Sana Khan1,3, Sorin V Pislaru1

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.A., S.K., S.V.P., J.J.T., E.A.E.-A., K.M., D.O., S.A.L., R.P., C.E.L., R.B.M., P.A.P., J.K.O., V.T.N.).

Circulation. Cardiovascular Imaging
|July 12, 2021
PubMed

Insights

High-gradient signals in atrial fibrillation (AF) low-gradient aortic stenosis (AS) indicate severe disease and increased mortality risk. Identifying these signals is crucial for accurate AS assessment and patient outcomes.

Area of Science:

  • Cardiology
  • Echocardiography
  • Valvular Heart Disease

Background:

  • Atrial fibrillation (AF) can create a low-flow state, potentially underestimating aortic stenosis (AS) severity.
  • Current practice averages Doppler signals, masking severe AS indicators like high-velocity signals (HS) in AF.
  • The significance of HS in low-gradient AS (LGAS) within the context of AF requires further investigation.

Purpose of the Study:

  • To determine the clinical significance of high-velocity signals (HS) in patients with low-gradient aortic stenosis (LGAS) and atrial fibrillation (AF).
  • To assess the association between HS, aortic valve calcium scores (AVCS), and mortality risk in patients with LGAS and AF.

Main Methods:

  • A cohort of 1,541 patients with severe AS (aortic valve area ≤1 cm², LVEF ≥50%) was analyzed.
  • Patients were classified into high-gradient AS (HGAS) and LGAS groups, and further stratified by rhythm: AF or sinus rhythm (SR).
  • Aortic valve calcium scores (AVCS) and mortality outcomes were assessed, with adjustments for clinical covariates.

Main Results:

  • High-velocity signals (HS) were present in 33% of AF-LGAS patients.
  • AVCS in AF-LGAS were comparable to SR-HGAS and higher when HS were present.
  • Mortality risk was significantly higher in AF-HGAS and AF-LGAS with HS compared to SR-HGAS.

Conclusions:

  • Severe AS is prevalent in AF-LGAS, with HS being a key indicator.
  • AVCS in AF-LGAS with HS suggest a severity comparable to HGAS.
  • The presence of HS in AF-LGAS identifies a high-risk subgroup with increased mortality.
Abstract

Keywords:
aortic stenosisatrial fibrillationcomorbiditymedical recordtomography

More Related Videos

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.6K
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery04:48

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Published on: November 28, 2018

8.1K

Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
100
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
108
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
109
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
58
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
91
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
63