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Editorial Asymptomatic Patients With Severe Aortic Stenosis Are Not All Created Equal A Role for Stress Performance and Heart Rate Recovery During Stress Echocardiography? Linda D. Gillam, MD, MPH; Leo Marcoff, MD ortic stenosis (AS) is a relentless disease that, once in left ventricular ejection fraction have also been shown to 5–8 Asymptomatic, carries a grim prognosis with 2-year be predictive of spontaneous symptom onset, symptom- 5,7 5–7 survival in the absence of aortic valve replacement (AVR) driven AVR, and sudden cardiac death. However, the link of <50%. Associated left ventricular systolic dysfunction between ESE results other than symptoms and outcomes has defined as a left ventricular ejection fraction of <50% is also not been entirely consistent, and death has been a rare event prognostically important, so that symptoms or reduced left typically occurring only after patients have become symp- 6,7 ventricular ejection fraction carry class I indications for AVR tomatic. In particular, ECG changes have been reported in both the American College of Cardiology and American to be inadequately discriminating, particularly in women. Heart Association (ACC/AHA) and the European Society of Thus, these ESE measures of test positivity carry no (EKG Cardiology (ESC) guidelines for the management of
Circulation: Cardiovascular Imaging – Wolters Kluwer Health
Published: Jul 1, 2016
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