PMID- 34136710
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210619
IS  - 2434-0790 (Electronic)
IS  - 2434-0790 (Linking)
VI  - 3
IP  - 6
DP  - 2021 May 26
TI  - Left Ventricular Hypertrophic Change Indicating Poor Prognosis in Patients With 
      Normal-Flow, Low-Gradient Severe Aortic Stenosis With Preserved Left Ventricular 
      Ejection Fraction.
PG  - 345-353
LID - 10.1253/circrep.CR-21-0011 [doi]
AB  - Background: Risk stratification of normal-flow, low-gradient (NFLG) severe aortic 
      stenosis (SAS) with preserved left ventricular (LV) ejection fraction (EF) 
      remains unclear. Methods and Results: Of 289 consecutive patients diagnosed with 
      SAS by aortic valve area <1.0 cm(2), 66 with NFLG-SAS (stroke volume index >35 
      mL/m(2), mean pressure gradient <40 mmHg, LVEF >/=50%) were enrolled in this study; 
      patients with bicuspid aortic valve, acute coronary syndrome, hemodialysis, or a 
      history of aortic valve replacement (AVR) were excluded. Adverse events (AEs) 
      were defined as cardiovascular death, hospitalization for heart failure, and 
      deteriorating condition requiring AVR. Factors associated with AEs were 
      investigated using a Cox proportional hazards model. Over a median of 675 days of 
      follow-up, 25 AEs were recorded: 4 cardiovascular deaths, 12 hospitalizations for 
      heart failure, and 9 patients requiring AVR. In addition, there were 14 events of 
      progression to high-gradient SAS. Multivariable analysis showed significant 
      associations between AEs and the presence of symptoms (hazard ratio [HR] 10.276; 
      95% confidence interval [CI] 3.724-28.357; P<0.001), LV hypertrophy (LV mass 
      index >115 and >95 mg/m(2) for males and females, respectively; HR 3.257; 95% CI 
      1.172-9.050; P=0.024), and tricuspid regurgitation (TR) velocity (HR 2.761; 95% 
      CI 1.246-6.118; P=0.012). Conclusions: The presence of symptoms, LV hypertrophy, 
      and high TR velocity could be reliable prognostic indicators and may require 
      watchful waiting for timely AVR in patients with NFLG-SAS.
CI  - Copyright (c) 2021, THE JAPANESE CIRCULATION SOCIETY.
FAU - Kawada, Yu
AU  - Kawada Y
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences Nagoya Japan.
FAU - Kitada, Shuichi
AU  - Kitada S
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences Nagoya Japan.
FAU - Hachiya, Kenta
AU  - Hachiya K
AD  - Division of Cardiology, Nagoya City University East Medical Center Nagoya Japan.
FAU - Kato, Marina
AU  - Kato M
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences Nagoya Japan.
FAU - Nakasuka, Kosuke
AU  - Nakasuka K
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences Nagoya Japan.
FAU - Kikuchi, Shohei
AU  - Kikuchi S
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences Nagoya Japan.
FAU - Seo, Yoshihiro
AU  - Seo Y
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences Nagoya Japan.
FAU - Ohte, Nobuyuki
AU  - Ohte N
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences Nagoya Japan.
LA  - eng
PT  - Journal Article
DEP - 20210526
PL  - Japan
TA  - Circ Rep
JT  - Circulation reports
JID - 101746642
PMC - PMC8180370
OTO - NOTNLM
OT  - Left ventricular hypertrophy
OT  - Normal-flow, low-gradient severe aortic stenosis
OT  - Preserved left ventricular ejection fraction
OT  - Prognosis
COIS- Y.S. is a member of Circulation Reports' Editorial Team. The authors have no 
      financial relationship with any commercial entity that has an interest in the 
      subject of this manuscript, and all authors declare no potential conflicts of 
      interest.
EDAT- 2021/06/18 06:00
MHDA- 2021/06/18 06:01
PMCR- 2021/05/26
CRDT- 2021/06/17 06:50
PHST- 2021/06/17 06:50 [entrez]
PHST- 2021/06/18 06:00 [pubmed]
PHST- 2021/06/18 06:01 [medline]
PHST- 2021/05/26 00:00 [pmc-release]
AID - 10.1253/circrep.CR-21-0011 [doi]
PST - epublish
SO  - Circ Rep. 2021 May 26;3(6):345-353. doi: 10.1253/circrep.CR-21-0011.