Author + information
- Received April 24, 2012
- Revision received October 11, 2012
- Accepted October 18, 2012
- Published online February 1, 2013.
- Marie-Annick Clavel, DVM, PhD⁎,
- Pierre Vladimir Ennezat, MD†,
- Sylvestre Maréchaux, MD†,
- Jean G. Dumesnil, MD⁎,
- Romain Capoulade, MS⁎,
- Zeineb Hachicha, MD⁎,
- Patrick Mathieu, MD⁎,
- Annaïk Bellouin, MD†,
- Sébastien Bergeron, MD⁎,
- Patrick Meimoun, MD‡,
- Marie Arsenault, MD⁎,
- Thierry Le Tourneau, MD§,
- Agnès Pasquet, MD∥,
- Christian Couture, MD⁎ and
- Philippe Pibarot, DVM, PhD⁎,⁎ ()
- ↵⁎Address for correspondence:
Dr. Philippe Pibarot, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec, Quebec G1V-4G5, Canada
The objective of this study was to examine the value of stress-echocardiography in patients with paradoxical low-flow, low-gradient (PLFLG) aortic stenosis (AS). The projected aortic valve area (AVAProj) at a normal flow rate was calculated in 55 patients with PLFLG AS. In the subset of patients (n = 13) who underwent an aortic valve replacement within 3 months after stress echocardiography, AVAProj correlated better with the valve weight compared to traditional resting and stress echocardiographic parameters of AS severity (AVAProj: r = −0.78 vs. other parameters: r = 0.46 to 0.56). In the whole group (N = 55), 18 (33%) patients had an AVAProj >1.0 cm2, being consistent with the presence of pseudo severe AS. The AVAProj was also superior to traditional parameters of stenosis severity for predicting outcomes (hazard ratio: 1.32/0.1 cm2 decrease in AVAProj). In patients with PLFLG AS, the measurement of AVAproj derived from stress echocardiography is helpful to determine the actual severity of the stenosis and predict risk of adverse events.
- aortic stenosis
- dobutamine stress echocardiography
- exercise stress echocardiography
- low-flow aortic stenosis
This work was supported by a grant (#57745) from the Canadian Institutes of Health Research (CIHR), Ottawa, Ontario, Canada. Dr. Pibarot holds the Canada Research Chair in Valvular Heart Diseases, Canadian Institutes of Health Research. Dr. Mathieu is a research scholar from the Fonds de Recherches en Santé du Québec, Montreal, Canada. Dr. Clavel holds a Vanier Canada Graduate Scholarship, CIHR. All other authors have reported they have no relationships relevant to the contents of this paper to disclose.
- Received April 24, 2012.
- Revision received October 11, 2012.
- Accepted October 18, 2012.
- American College of Cardiology Foundation