Low gradient "severe" aortic stenosis with preserved left ventricular ejection fraction.
Low gradient "severe" aortic stenosis with preserved left ventricular ejection fraction.
复制标题
低梯度“严重”主动脉瓣狭窄，左心室射血分数保留。
DOI：
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发表时间：
2012
影响因子：
2.4
通讯作者：
A. Ozkan
中科院分区：
文献类型：
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作者：
A. Ozkan
在发达国家，主动脉瓣狭窄（AS）是最常见的瓣膜性心脏病表现，并且由于人口老龄化，其患病率正在增加。准确诊断疾病过程和确定其严重程度是至关重要的临床决策。尽管目前的指南建议测量跨瓣压差、最大流速和主动脉瓣面积来确定疾病严重程度，但疾病严重程度分级不一致仍然是临床实践中的常见问题。最近的研究表明，反常的低流量和/或低梯度，严重的AS患者处于疾病过程的更晚期，预后较差。这种表现模式可能导致低估症状和AVR的不适当延迟。因此，应仔细评估这种具有挑战性的临床情况，特别是在有症状的患者中，并应单独定制临床决策。
In developed nations, aortic stenosis (AS) is the most common valvular heart disease presentation, and its prevalence is increasing due to aging populations. Accurate diagnosis of the disease process and determination of its severity are essential in clinical decision-making. Although current guidelines recommend measuring transvalvular gradients, maximal velocity, and aortic valve area in determining the disease severity, inconsistent grading of disease severity remains a common problem in clinical practice. Recent studies suggest that patients with paradoxical low-flow and/or low-gradient, severe AS are at a more advanced stage of the disease process and have a poorer prognosis. This mode of presentation may lead to an undervaluation of symptoms and inappropriate delay of AVR. Therefore, this challenging clinical situation should be carefully assessed in particular in symptomatic patients and clinical decisions should be tailored individually.