open access

Vol 79, No 5 (2021)
Original article
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Polish Multicenter Registry (Pol-LAS-SE registry). Stress echocardiography in low-gradient aortic stenosis in Poland: numbers, settings, results, complications and clinical practice

Edyta Płońska-Gościniak, Jarosław D Kasprzak, Tomasz Kukulski, Katarzyna Mizia-Stec, Maciej Haberka, Ludmiła Daniłowicz, Małgorzata Peregud-Pogorzelska, Janusz Kochanowski, Małgorzata Knapp, Mirosław Marciniak, Barbara Brzezińska, Piotr Gościniak, Grzegorz Skonieczny, Beata Zaborska, Ewa Flis-Zaremba, Dariusz Kosior, Wojciech Witkiewicz, Barbara Zawiślak, Danuta Sorysz, Wojciech Kosmala
DOI: 10.33963/KP.15929
·
Pubmed: 34125924
·
Kardiol Pol 2021;79(5):517-524.

open access

Vol 79, No 5 (2021)
Original article

Abstract

Background: The diagnostic workup of low-gradient aortic stenosis (LG AS) is a challenge in clinical practice.
Aims: Our goal was to assess the diagnostic value of stress echocardiography (SE) performed in patients with undefined LG AS with low and preserved ejection fraction (EF) and the impact of its result on therapeutic decisions in Polish third level of reference.
Methods: All the patients with LG AS and with SE performed were recruited in 16 Polish cardiology departments between 2016 and 2019. The main exclusion criteria were as follows: moderate or severe aortic or mitral regurgitation and mitral stenosis.
Results: The study group included 163 patients (52% males) with LG AS who underwent SE for adequate diagnostic and therapeutic decision. In 14 patients DSE was non-diagnostic. The mean aortic valve (AV) pressure gradient was 24.1 (7.3) mm Hg, while an AV area was 0.86 (0.2) cm2. Among 149 patients with conclusive DSE, severe AS was found in 59.8%, pseudo-severe in 22%, and moderate AS in 18%. There were no cases of death or vascular events related to DSE. Among 142 patients 63 (44%) patients had an aortic valve intervention in a follow-up (median: 208 days; lower-upper quartile: 73–531 days). Based on the result of the DSE test, severe AS was significantly more often associated with qualification to interventional treatment compared to the moderate and pseudo-severe subgroups (P <0.0001).
Conclusions: The DSE test in severe AS is a valuable diagnostic tool in patients with LG AS in Poland.

Abstract

Background: The diagnostic workup of low-gradient aortic stenosis (LG AS) is a challenge in clinical practice.
Aims: Our goal was to assess the diagnostic value of stress echocardiography (SE) performed in patients with undefined LG AS with low and preserved ejection fraction (EF) and the impact of its result on therapeutic decisions in Polish third level of reference.
Methods: All the patients with LG AS and with SE performed were recruited in 16 Polish cardiology departments between 2016 and 2019. The main exclusion criteria were as follows: moderate or severe aortic or mitral regurgitation and mitral stenosis.
Results: The study group included 163 patients (52% males) with LG AS who underwent SE for adequate diagnostic and therapeutic decision. In 14 patients DSE was non-diagnostic. The mean aortic valve (AV) pressure gradient was 24.1 (7.3) mm Hg, while an AV area was 0.86 (0.2) cm2. Among 149 patients with conclusive DSE, severe AS was found in 59.8%, pseudo-severe in 22%, and moderate AS in 18%. There were no cases of death or vascular events related to DSE. Among 142 patients 63 (44%) patients had an aortic valve intervention in a follow-up (median: 208 days; lower-upper quartile: 73–531 days). Based on the result of the DSE test, severe AS was significantly more often associated with qualification to interventional treatment compared to the moderate and pseudo-severe subgroups (P <0.0001).
Conclusions: The DSE test in severe AS is a valuable diagnostic tool in patients with LG AS in Poland.

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Keywords

aortic stenosis, dobutamine stress echocardiography, low gradient aortic stenosis, stress echocardiography

About this article
Title

Polish Multicenter Registry (Pol-LAS-SE registry). Stress echocardiography in low-gradient aortic stenosis in Poland: numbers, settings, results, complications and clinical practice

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 79, No 5 (2021)

Article type

Original article

Pages

517-524

DOI

10.33963/KP.15929

Pubmed

34125924

Bibliographic record

Kardiol Pol 2021;79(5):517-524.

Keywords

aortic stenosis
dobutamine stress echocardiography
low gradient aortic stenosis
stress echocardiography

Authors

Edyta Płońska-Gościniak
Jarosław D Kasprzak
Tomasz Kukulski
Katarzyna Mizia-Stec
Maciej Haberka
Ludmiła Daniłowicz
Małgorzata Peregud-Pogorzelska
Janusz Kochanowski
Małgorzata Knapp
Mirosław Marciniak
Barbara Brzezińska
Piotr Gościniak
Grzegorz Skonieczny
Beata Zaborska
Ewa Flis-Zaremba
Dariusz Kosior
Wojciech Witkiewicz
Barbara Zawiślak
Danuta Sorysz
Wojciech Kosmala

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