Author + information
- Received August 31, 2012
- Revision received November 20, 2012
- Accepted November 26, 2012
- Published online February 1, 2013.
- Anumeha Tandon, MD and
- Paul A. Grayburn, MD⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Paul A. Grayburn, Baylor Heart and Vascular Institute, 621 North Hall Street, Suite H030, Dallas, Texas 75226
Although most patients with severe aortic stenosis (AS) have high peak velocity and mean transvalvular gradient, there is a subset of patients with low-flow, low-gradient severe AS (LGSAS). Assessment and management of such patients can be difficult and dobutamine echocardiography has been recommended to distinguish those with pseudo-AS (low calculated AVA due to insufficient flow to fully open the valve) from those with contractile reserve and true LGSAS, who may have good outcomes with surgery. More recently, a group of patients with LGSAS and preserved LV function have been identified. These patients are often elderly with hypertension, small left ventricular cavities, and concentric left ventricular hypertrophy. Because cardiac imaging plays a vital role in hemodynamic classification of patients with suspected LGSAS and determining appropriate management, this review was undertaken to summarize the current state of knowledge of this important but complex condition.
Dr. Tandon has reported that he has no relationships relevant to the contents of this paper to disclose. Dr. Grayburn has received grant support from Abbott Vascular and Medtronic, has consulted for Abbott Vascular and Bracco Diagnostics, and serves as the Echo Core Lab for ValTech Cardio and Guided Delivery Systems.
- Received August 31, 2012.
- Revision received November 20, 2012.
- Accepted November 26, 2012.
- American College of Cardiology Foundation