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Assessment of Normal-Flow Aortic Stenosis

Assessment of Normal-Flow Aortic Stenosis Editorial Delving Too Deep? Caroline Bleakley, MRCP, MD; Mark J. Monaghan, FRCP, PhD he increasing complexity of assessing aortic stenosis offset between symptomatic improvement and ventricular T(AS) will perhaps haunt cardiologists in years to come. ‘healing’, the authors have carefully considered many poten- Did we over-complicate it, were we overly ambitious in try- tial factors that could have influenced remodeling, and indeed ing to identify those who might benefit from intervention? whether NFLG even represents the same truly severe AS as its These are questions that we will be held accountable for by high-gradient counterpart. the vast numbers of patients who now carry some form of this diagnosis, and we have reason to be concerned. The previ- Remodeling and Global Left ously accepted interventional indicators in AS, predominantly Ventricular Afterload defined by a mean gradient >40 mm Hg and AVA <1 cm with Firstly, one of the highlighted outcomes in this study involved accompanying symptoms, have now almost become a distant remodeling and its lack of improvement in NFLG disease memory. There are currently 4 different subtypes: classic after surgery. Remodeling in AS is predominantly related to low-flow low-gradient (LFLG), paradoxical LFLG, normal- the pressure load created by the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Circulation: Cardiovascular Imaging Wolters Kluwer Health

Assessment of Normal-Flow Aortic Stenosis

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References (16)

Publisher
Wolters Kluwer Health
Copyright
© 2017 American Heart Association, Inc.
ISSN
1941-9651
eISSN
1942-0080
DOI
10.1161/CIRCIMAGING.117.007293
Publisher site
See Article on Publisher Site

Abstract

Editorial Delving Too Deep? Caroline Bleakley, MRCP, MD; Mark J. Monaghan, FRCP, PhD he increasing complexity of assessing aortic stenosis offset between symptomatic improvement and ventricular T(AS) will perhaps haunt cardiologists in years to come. ‘healing’, the authors have carefully considered many poten- Did we over-complicate it, were we overly ambitious in try- tial factors that could have influenced remodeling, and indeed ing to identify those who might benefit from intervention? whether NFLG even represents the same truly severe AS as its These are questions that we will be held accountable for by high-gradient counterpart. the vast numbers of patients who now carry some form of this diagnosis, and we have reason to be concerned. The previ- Remodeling and Global Left ously accepted interventional indicators in AS, predominantly Ventricular Afterload defined by a mean gradient >40 mm Hg and AVA <1 cm with Firstly, one of the highlighted outcomes in this study involved accompanying symptoms, have now almost become a distant remodeling and its lack of improvement in NFLG disease memory. There are currently 4 different subtypes: classic after surgery. Remodeling in AS is predominantly related to low-flow low-gradient (LFLG), paradoxical LFLG, normal- the pressure load created by the

Journal

Circulation: Cardiovascular ImagingWolters Kluwer Health

Published: Dec 1, 2017

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