1. Johannes Steiner et al. JACC 2017;70:3026-3041
Pathophysiology, Incidence, and Treatment Options for Distinct Phenotypes of Aortic Stenosis With Reduced Ejection Fraction Progression of aortic valve stenosis and its effect on ventricular remodeling can be observed as parallel developments. Significant aortic stenosis with concomitant systolic dysfunction can be distinguished by gradients and flow reserve detected through dobutamine stress echocardiography and divided in several phenotypes including true severe aortic stenosis with preserved gradients, low-flow low-gradient aortic stenosis with and without flow reserve, and pseudo-severe aortic stenosis. The risk benefit ratio of mechanical interventions for these subgroups is distinctly different. AS = aortic stenosis; AVR = aortic valve replacement; DSE = dobutamine stress echo; ESC = European Society of Cardiologists; HFrEF = heart failure and reduced ejection fraction; LF-LG = low flow-low gradient; SAVR = surgical aortic valve replacement; STS = Society of Thoracic Surgeons; TAVR = transcatheter aortic valve replacement.
Johannes Steiner et al. JACC 2017;70:
2017 American College of Cardiology Foundation