Discordant Grading of Aortic Stenosis Severity: Echocardiographic Predictors of Survival Benefit Associated With Aortic Valve Replacement

JACC: Cardiovascular Imaging

Volumn 9, Issue 7, 2016, Pages 797-805

  Berthelot Richer, Maxime ^a   Pibarot, Philippe ^a   Capoulade, Romain ^a   Dumesnil, Jean G ^a   Dahou, Abdellaziz ^a   Thebault, Christophe ^a   Le Ven, Florent ^a   Clavel, Marie Annick ^a  

^a LAVAL UNIVERSITY   (Canada)

Author keywords

aortic valve stenosis; Doppler echocardiography; surgery; survival; valvular heart disease

Indexed keywords

AGED; ALGORITHM; AORTA VALVE REPLACEMENT; AORTA VALVE STENOSIS; ARTICLE; CARDIOVASCULAR PARAMETERS; CLINICAL ASSESSMENT; COMPARATIVE STUDY; CONTROLLED STUDY; DISCORDANT AORTIC GRADING; DISEASE CLASSIFICATION; DISEASE SEVERITY; DOPPLER ECHOCARDIOGRAPHY; FEMALE; FOLLOW UP; HUMAN; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PRIORITY JOURNAL; PROSPECTIVE STUDY; RADIOLOGICAL PARAMETERS; SURVIVAL RATE; AORTIC VALVE; AORTIC VALVE STENOSIS; BLOOD VESSEL TRANSPLANTATION; CHI SQUARE DISTRIBUTION; DIAGNOSTIC IMAGING; HEMODYNAMICS; KAPLAN MEIER METHOD; MIDDLE AGED; MORTALITY; MULTIVARIATE ANALYSIS; PATHOPHYSIOLOGY; PREDICTIVE VALUE; PROPENSITY SCORE; PROPORTIONAL HAZARDS MODEL; RETROSPECTIVE STUDY; RISK ASSESSMENT; RISK FACTOR; SEVERITY OF ILLNESS INDEX; TIME FACTOR; TREATMENT OUTCOME; VERY ELDERLY;

AGED; AGED, 80 AND OVER; ALGORITHMS; AORTIC VALVE; AORTIC VALVE STENOSIS; BLOOD VESSEL PROSTHESIS IMPLANTATION; CHI-SQUARE DISTRIBUTION; ECHOCARDIOGRAPHY, DOPPLER; FEMALE; HEMODYNAMICS; HUMANS; KAPLAN-MEIER ESTIMATE; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PREDICTIVE VALUE OF TESTS; PROPENSITY SCORE; PROPORTIONAL HAZARDS MODELS; RETROSPECTIVE STUDIES; RISK ASSESSMENT; RISK FACTORS; SEVERITY OF ILLNESS INDEX; TIME FACTORS; TREATMENT OUTCOME;

EID: 84975492024     PISSN: 1936878X     EISSN: 18767591     Source Type: Journal    
DOI: 10.1016/j.jcmg.2015.09.026     Document Type: Article

References (30)

1. 1 Nishimura, R.A., Otto, C.M., Bonow, R.O., et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary. A report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol 63 (2014), 2438–2488.
2. 2 Vahanian, A., Iung, B., The new ESC/EACTS guidelines on the management of valvular heart disease. Arch Cardiovasc Dis 105 (2012), 465–467.
3. 3 Baumgartner, H., Hung, J., Bermejo, J., et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr 22 (2009), 1–23.
4. 4 Barasch, E., Fan, D., Chukwu, E.O., et al. Severe isolated aortic stenosis with normal left ventricular systolic function and low transvalvular gradients: pathophysiologic and prognostic insights. J Heart Valve Dis 17 (2008), 81–88.
5. 5 Minners, J., Allgeier, M., Gohlke-Baerwolf, C., Kienzle, R.P., Neumann, F.J., Jander, N., Inconsistent grading of aortic valve stenosis by current guidelines: haemodynamic studies in patients with apparently normal left ventricular function. Heart 96 (2010), 1463–1468.
6. 6 Belkin, R.N., Khalique, O., Aronow, W.S., Ahn, C., Sharma, M., Outcomes and survival with aortic valve replacement compared with medical therapy in patients with low-, moderate-, and severe-gradient severe aortic stenosis and normal left ventricular ejection fraction. Echocardiography 28 (2011), 378–387.
7. 7 Clavel, M.A., Messika-Zeitoun, D., Pibarot, P., et al. The complex nature of discordant severe calcified aortic valve disease grading: new insights from combined Doppler-echocardiographic and computed tomographic study. J Am Coll Cardiol 62 (2013), 2329–2338.
8. 8 Quinones, M.A., Otto, C.M., Stoddard, M., Waggoner, A., Zoghbi, W.A., Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 15 (2002), 167–184.
9. 9 Kadem, L., Dumesnil, J.G., Rieu, R., Durand, L.G., Garcia, D., Pibarot, P., Impact of systemic hypertension on the assessment of aortic stenosis. Heart 91 (2005), 354–361.
10. 10 Zoghbi, W.A., Low-gradient “severe” aortic stenosis with normal systolic function: time to refine the guidelines?. Circulation 123 (2011), 838–840.
11. 11 Minners, J., Allgeier, M., Gohlke-Baerwolf, C., Kienzle, R.P., Neumann, F.J., Jander, N., Inconsistencies of echocardiographic criteria for the grading of aortic valve stenosis. Eur Heart J 29 (2008), 1043–1048.
12. 12 Malouf, J., Le, T.T., Pellikka, P., et al. Aortic valve stenosis in community medical practice: determinants of outcome and implications for aortic valve replacement. J Thorac Cardiovasc Surg 144 (2012), 1421–1427.
13. 13 Tarantini, G., Covolo, E., Razzolini, R., et al. Valve replacement for severe aortic stenosis with low transvalvular gradient and left ventricular ejection fraction exceeding 0.50. Ann Thorac Surg 91 (2011), 1808–1815.
14. 14 Ozkan, A., Hachamovitch, R., Kapadia, S.R., Tuzcu, E.M., Marwick, T.H., Impact of aortic valve replacement on outcome of symptomatic patients with severe aortic stenosis with low gradient and preserved left ventricular ejection fraction. Circulation 128 (2013), 622–631.
15. 15 Lancellotti, P., Tribouilloy, C., Hagendorff, A., et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). Eur J Echocardiogr 11 (2010), 223–244.
16. 16 Lancellotti, P., Moura, L., Pierard, L.A., et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr 11 (2010), 307–332.
17. 17 Lang, R.M., Badano, L.P., Mor-Avi, V., et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28 (2015), 1–39.
18. 18 Dumesnil, J.G., Pibarot, P., Carabello, B., Paradoxical low flow and/or low gradient severe aortic stenosis despite preserved left ventricular ejection fraction: implications for diagnosis and treatment. Eur Heart J 31 (2010), 281–289.
19. 19 Pellikka, P.A., Nishimura, R.A., Bailey, K.R., Tajik, A.J., The natural history of adults with asymptomatic, hemodynamically significant aortic stenosis. J Am Coll Cardiol 15 (1990), 1012–1017.
20. 20 Otto, C.M., Burwash, I.G., Legget, M.E., et al. Prospective study of asymptomatic valvular aortic stenosis. Clinical, echocardiographic, and exercise predictors of outcome. Circulation 95 (1997), 2262–2270.
21. 21 Rosenhek, R., Binder, T., Porenta, G., et al. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med 343 (2000), 611–617.
22. 22 Pellikka, P.A., Sarano, M.E., Nishimura, R.A., et al. Outcome of 622 adults with asymptomatic, hemodynamically significant aortic stenosis during prolonged follow-up. Circulation 111 (2005), 3290–3295.
23. 23 Hachicha, Z., Dumesnil, J.G., Bogaty, P., Pibarot, P., Paradoxical low flow, low gradient severe aortic stenosis despite preserved ejection fraction is associated with higher afterload and reduced survival. Circulation 115 (2007), 2856–2864.
24. 24 Clavel, M.A., Dumesnil, J.G., Capoulade, R., Mathieu, P., Sénéchal, M., Pibarot, P., Outcome of patients with aortic stenosis, small valve area and low-flow, low-gradient despite preserved left ventricular ejection fraction. J Am Coll Cardiol 60 (2012), 1259–1267.
25. 25 Pai, R.G., Varadarajan, P., Razzouk, A., Survival benefit of aortic valve replacement in patients with severe aortic stenosis with low ejection fraction and low gradient with normal ejection fraction. Ann Thorac Surg 86 (2008), 1781–1789.
26. 26 Eleid, M.F., Sorajja, P., Michelena, H.I., Malouf, J.F., Scott, C.G., Pellikka, P.A., Flow-gradient patterns in severe aortic stenosis with preserved ejection fraction: clinical characteristics and predictors of survival. Circulation 128 (2013), 1781–1789.
27. 27 Maes, F., Boulif, J., Pierard, S., et al. Natural history of paradoxical low gradient “severe” aortic stenosis. Circ Cardiovasc Imaging 7 (2014), 714–722.
28. 28 Tribouilloy, C., Rusinaru, D., Marechaux, S., et al. Low-gradient, low-flow severe aortic stenosis with preserved left ventricular ejection fraction: characteristics, outcome, and implications for surgery. J Am Coll Cardiol 65 (2015), 55–66.
29. 29 Pibarot, P., Clavel, M.A., Management of paradoxical low-flow, low-gradient aortic stenosis: need for an integrated approach, including assessment of symptoms, hypertension, and stenosis severity. J Am Coll Cardiol 65 (2015), 67–71.
30. 30 Clavel, M.A., Ennezat, P.V., Maréchaux, S., et al. Stress echocardiography to assess stenosis severity and predict outcome in patients with paradoxical low-flow, low-gradient aortic stenosis and preserved LVEF. J Am Coll Cardiol Img 6 (2013), 175–183.