Типи аортального стенозу тяжкого ступеня
Severe AS type | Vmax | Valve area | LV EF | DVI | Other |
|---|---|---|---|---|---|
High gradient | ≥ 4.0 m/second | ≤ 1.0 cm2 | ≥ 50% | < 0.25 | — |
Low-flow, low-gradient with reduced EF | < 4.0 m/second | ≤ 1.0 cm2 | < 50% | < 0.25 | Distinguish from pseudostenosis with low-dose dobutamine echocardiography, valve area < 1.0 cm2, Vmax > 4.0 m/second |
Low-flow, low-gradient with normal EF (paradoxical low-flow AS) | < 4.0 m/second | ≤ 1.0 cm2 | ≥ 50% with small hypertrophied LV | < 0.25 | Distinguish from non-severe AS by stroke volume index < 35 mL/m2 measured when patient is normotensive |
AS = aortic stenosis; DVI = Doppler velocity index, the ratio of LV outflow tract to aortic velocity; LV EF = left ventricular ejection fraction; Vmax = peak forward velocity across the aortic valve. | |||||
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