Patients with aortic stenosis (AS) may have a severely reduced aortic valve area (AVA) and a paradoxically low mean gradient (MG). Although this condition is well known in presence of left ventricular (LV) dysfunction, it has recently been observed that it can be associated with normal ejection fraction (EF) as well. Since the prevalence of this condition with respect to LV function is not well defined, we aimed to evaluate the distribution of patients with severely reduced valve area and low MG in a group of patients regardless of EF over a set period of time. We retrospectively identified consecutive patients with severe AS (defined as aortic valve area <0.6 cmq/mq) from our echo data-base. Low MG was defined as < 40 mmHg. Left ventricular systolic dysfunction was considered as EF< 50%. 167 patients with AVA <0.6 cmq/mq formed the study population. 94 (56%) patients were characterized by high MG and 73 (44%) by low MG. Among patients with low MG, 38 were characterized by normal EF and 35 by reduced EF. Differences among groups are shown in Table 1. In this echocardiographic series of consecutive patients, the prevalence of low MG despite severely reduced AVA was high. The distribution of low MG was similar in presence of reduced and preserved EF (21 and 23% of the overall population respectively).


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  • Accepted: 31 May 2012
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