May 4, 2026Journal of the American College of Cardiology

AVR was associated with reduced mortality in patients with LF-LG AS (HR: 0.44; 95% CI: 0.25 to 0.77) and NF-LG AS (HR: 0.48; 95% CI: 0.28 to 0.83).

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Why the study?

In patients with aortic stenosis and preserved LVEF, low mean transvalvular gradient and small aortic valve area raise uncertainty regarding stenosis severity and the survival benefit of AVR.

Does aortic valve replacement improve survival in patients with low-gradient aortic stenosis and preserved LVEF?

Population

Eighteen studies of patients with low-gradient AS and preserved LVEF, high-gradient AS, or moderate AS

Comparison

AVR vs no AVR, and comparisons across AS subtypes

Design

Meta-analysis of studies published between 2005 and 2015

Authors

VDVíctor Dayan GVGustavo Vignolo JMJulien Magné

Discussion

Member takes

Overview

May support AVR in LF-LG AS but should not change practice; leaves open benefit pending randomized trials.

Structured PICO

Does aortic valve replacement improve survival in patients with low-gradient aortic stenosis and preserved LVEF?

Population

18 studies of patients with low-gradient (LG) aortic stenosis (AS) and preserved left ventricular ejection fraction, including paradoxical low-flow, low-gradient (LF-LG) (stroke volume index <35 ml/m2) and normal-flow, low-gradient (NF-LG), and those with high-gradient (≥ 40 mm Hg) AS or moderate AS.

Intervention

Aortic valve replacement (AVR)

Comparator

No AVR

Outcome

Survival benefit associated with AVRhard clinical

Aortic valve replacement is associated with a significant survival benefit in patients with low-flow, low-gradient and normal-flow, low-gradient aortic stenosis with preserved LVEF.

Cite This Study

Dayan et al. (2015) studied this question.

synapsesocial.com/papers/69f8b8de037bf4ee0479fb57 https://doi.org/10.1016/j.jacc.2015.09.076

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May 4, 2026Journal of the American College of Cardiology

AVR was associated with reduced mortality in patients with LF-LG AS (HR: 0.44; 95% CI: 0.25 to 0.77) and NF-LG AS (HR: 0.48; 95% CI: 0.28 to 0.83).

View Full Paper

Ask AI

Bookmark

Why the study?

In patients with aortic stenosis and preserved LVEF, low mean transvalvular gradient and small aortic valve area raise uncertainty regarding stenosis severity and the survival benefit of AVR.

Does aortic valve replacement improve survival in patients with low-gradient aortic stenosis and preserved LVEF?

Population

Eighteen studies of patients with low-gradient AS and preserved LVEF, high-gradient AS, or moderate AS

Comparison

AVR vs no AVR, and comparisons across AS subtypes

Design

Meta-analysis of studies published between 2005 and 2015

Authors

VDVíctor Dayan GVGustavo Vignolo JMJulien Magné

Discussion

Member takes

Overview

May support AVR in LF-LG AS but should not change practice; leaves open benefit pending randomized trials.

Structured PICO

Does aortic valve replacement improve survival in patients with low-gradient aortic stenosis and preserved LVEF?

Population

Intervention

Aortic valve replacement (AVR)

Comparator

No AVR

Outcome

Survival benefit associated with AVRhard clinical

Aortic valve replacement is associated with a significant survival benefit in patients with low-flow, low-gradient and normal-flow, low-gradient aortic stenosis with preserved LVEF.

Cite This Study

Dayan et al. (2015) studied this question.

synapsesocial.com/papers/69f8b8de037bf4ee0479fb57 https://doi.org/10.1016/j.jacc.2015.09.076

View Full Paper

Ask AI

Bookmark