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http://hdl.handle.net/1942/38814
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DC Field | Value | Language |
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dc.contributor.author | STASSEN, Jan | - |
dc.contributor.author | Ewe, See Hooi | - |
dc.contributor.author | Singh, Gurpreet K. | - |
dc.contributor.author | Butcher, Steele C. | - |
dc.contributor.author | Hirasawa, Kensuke | - |
dc.contributor.author | Amanullah, Mohammed R. | - |
dc.contributor.author | Pio, Stephan M. | - |
dc.contributor.author | Sin, Kenny Y. K. | - |
dc.contributor.author | Ding, Zee P. | - |
dc.contributor.author | Sia, Ching-Hui | - |
dc.contributor.author | Chew, Nicholas W. S. | - |
dc.contributor.author | Kong, William K. F. | - |
dc.contributor.author | Poh, Kian Keong | - |
dc.contributor.author | Leon, Martin B. | - |
dc.contributor.author | Pibarot, Philippe | - |
dc.contributor.author | Delgado, Victoria | - |
dc.contributor.author | Marsan, Nina Ajmone | - |
dc.contributor.author | Bax, Jeroen J. | - |
dc.date.accessioned | 2022-10-26T06:51:22Z | - |
dc.date.available | 2022-10-26T06:51:22Z | - |
dc.date.issued | 2022 | - |
dc.date.submitted | 2022-10-20T11:18:49Z | - |
dc.identifier.citation | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 80 (7) , p. 666 -676 | - |
dc.identifier.uri | http://hdl.handle.net/1942/38814 | - |
dc.description.abstract | BACKGROUND The prognostic implications of discordant grading in severe aortic stenosis (AS) are well known. However, the prevalence of different flow-gradient patterns and their prognostic implications in moderate AS are unknown. OBJECTIVES The purpose of this study was to investigate the occurrence and prognostic implications of different flow-gradient patterns in patients with moderate AS. METHODS Patients with moderate AS (aortic valve area >1.0 and <= 1.5 cm(2)) were identified and divided in 4 groups based on transvalvular mean gradient (MG), stroke volume index (SVi), and left ventricular ejection fraction (LVEF): concordant moderate AS (MG >= 20 mm Hg) and discordant moderate AS including 3 subgroups: normal-flow, lowgradient moderate AS (MG <20 mm Hg, SVi >= 35 mL/m(2), and LVEF >= 50%); "paradoxical" low-flow, low-gradient moderate AS (MG < 20 mm Hg, SVi <35 mL/m(2), and LVEF >= 50%) and "classical" low-flow, low-gradient moderate AS (MG <20 mm Hg and LVEF <50%). The primary endpoint was all-cause mortality. RESULTS Of 1,974 patients (age 73 +/- 10 years, 51% men) with moderate AS, 788 (40%) had discordant grading, and these patients showed significantly higher mortality rates than patients with concordant moderate AS (P < 0.001). On multivariable analysis, "paradoxical" low-flow, low-gradient (HR: 1.458; 95% CI: 1.072-1.983; P = 0.014) and "classical" low-flow, low-gradient (HR: 1.710; 95% CI: 1.270-2.303; P < 0.001) patterns but not the normal-flow, low-gradient moderate AS pattern were independently associated with all-cause mortality. CONCLUSIONS Discordant grading is frequently (40%) observed in patients with moderate AS. Low-flow, lowgradient patterns account for an important proportion of the discordant cases and are associated with increased mortality. These findings underline the need for better phenotyping patients with discordant moderate AS. (C) 2022 by the American College of Cardiology Foundation. | - |
dc.description.sponsorship | The Department of Cardiology of the Leiden University Medical Centre has received unrestricted research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. Dr Stassen has received funding from the European Society of Cardiology (ESC Training Grant App000064741). Dr Butcher has received funding from the European Society of Cardiology (ESC Research Grant App000080404). Dr Pibarot has received funding from Edwards Lifesciences, Medtronic, Pi-Cardia, and Cardiac Phoenix for echocardiography core laboratory analyses and research studies in the field of transcatheter valve therapies, for which he received no personal compensation; and has received lecture fees from Edwards Lifesciences and Medtronic. Dr Delgado has received speaker fees from Abbott Vascular, Edwards Lifesciences, Merck Sharp and Dohme, and GE Healthcare. Dr Marsan has received speaker fees from Abbott Vascular and GE Healthcare. Dr Bax received speaker fees from Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. | - |
dc.language.iso | en | - |
dc.publisher | ELSEVIER SCIENCE INC | - |
dc.rights | 2022 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION PUBLISHED BY ELSEVIER | - |
dc.subject.other | discordant grading | - |
dc.subject.other | low-flow | - |
dc.subject.other | low-gradient aortic stenosis | - |
dc.subject.other | moderate aortic stenosis | - |
dc.subject.other | mortality | - |
dc.title | Prevalence and Prognostic Implications of Discordant Grading and Flow-Gradient Patterns in Moderate Aortic Stenosis | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 676 | - |
dc.identifier.issue | 7 | - |
dc.identifier.spage | 666 | - |
dc.identifier.volume | 80 | - |
local.format.pages | 11 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Bax, JJ (corresponding author), Heart Lung Ctr, Dept Cardiol, Albinusdreef 2, NL-2300 RC Leiden, Netherlands. | - |
dc.description.notes | j.j.bax@lumc.nl | - |
local.publisher.place | STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.1016/j.jacc.2022.05.036 | - |
dc.identifier.pmid | 35953133 | - |
dc.identifier.isi | 000863524800002 | - |
dc.contributor.orcid | Stassen, Jan/0000-0001-9745-5498 | - |
local.provider.type | wosris | - |
local.description.affiliation | [Stassen, Jan; Singh, Gurpreet K.; Butcher, Steele C.; Hirasawa, Kensuke; Pio, Stephan M.; Delgado, Victoria; Marsan, Nina Ajmone; Bax, Jeroen J.] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands. | - |
local.description.affiliation | [Stassen, Jan] Jessa Hosp, Dept Cardiol, Hasselt, Belgium. | - |
local.description.affiliation | [Ewe, See Hooi; Amanullah, Mohammed R.; Sin, Kenny Y. K.; Ding, Zee P.] Natl Heart Ctr Singapore, Dept Cardiol, Singapore, Singapore. | - |
local.description.affiliation | [Butcher, Steele C.] Royal Perth Hosp, Dept Cardiol, Perth, WA, Australia. | - |
local.description.affiliation | [Sia, Ching-Hui; Chew, Nicholas W. S.; Kong, William K. F.; Poh, Kian Keong; Bax, Jeroen J.] Natl Univ Heart Ctr Singapore, Dept Cardiol, Singapore, Singapore. | - |
local.description.affiliation | [Leon, Martin B.] Columbia Univ, Irving Med Ctr, New York, NY USA. | - |
local.description.affiliation | [Leon, Martin B.] Columbia Univ, Cardiovasc Res Fdn, New York, NY USA. | - |
local.description.affiliation | [Pibarot, Philippe] Laval Univ, Quebec Heart & Lung Inst, Dept Cardiol, Quebec City, PQ, Canada. | - |
local.description.affiliation | [Bax, Jeroen J.] Univ Turku, Turku Heart Ctr, Turku, Finland. | - |
local.description.affiliation | [Bax, Jeroen J.] Turku Univ Hosp, Turku, Finland. | - |
local.uhasselt.international | yes | - |
item.contributor | STASSEN, Jan | - |
item.contributor | Ewe, See Hooi | - |
item.contributor | Singh, Gurpreet K. | - |
item.contributor | Butcher, Steele C. | - |
item.contributor | Hirasawa, Kensuke | - |
item.contributor | Amanullah, Mohammed R. | - |
item.contributor | Pio, Stephan M. | - |
item.contributor | Sin, Kenny Y. K. | - |
item.contributor | Ding, Zee P. | - |
item.contributor | Sia, Ching-Hui | - |
item.contributor | Chew, Nicholas W. S. | - |
item.contributor | Kong, William K. F. | - |
item.contributor | Poh, Kian Keong | - |
item.contributor | Leon, Martin B. | - |
item.contributor | Pibarot, Philippe | - |
item.contributor | Delgado, Victoria | - |
item.contributor | Marsan, Nina Ajmone | - |
item.contributor | Bax, Jeroen J. | - |
item.fullcitation | STASSEN, Jan; Ewe, See Hooi; Singh, Gurpreet K.; Butcher, Steele C.; Hirasawa, Kensuke; Amanullah, Mohammed R.; Pio, Stephan M.; Sin, Kenny Y. K.; Ding, Zee P.; Sia, Ching-Hui; Chew, Nicholas W. S.; Kong, William K. F.; Poh, Kian Keong; Leon, Martin B.; Pibarot, Philippe; Delgado, Victoria; Marsan, Nina Ajmone & Bax, Jeroen J. (2022) Prevalence and Prognostic Implications of Discordant Grading and Flow-Gradient Patterns in Moderate Aortic Stenosis. In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 80 (7) , p. 666 -676. | - |
item.accessRights | Open Access | - |
item.fulltext | With Fulltext | - |
crisitem.journal.issn | 0735-1097 | - |
crisitem.journal.eissn | 1558-3597 | - |
Appears in Collections: | Research publications |
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File | Description | Size | Format | |
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Prevalence and Prognostic Implications of Discordant Grading and Flow-Gradient Patterns in Moderate Aortic Stenosis.pdf | Published version | 1.43 MB | Adobe PDF | View/Open |
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