Research ArticleCardiology

Ventricular stroke work and vascular impedance refine the characterization of patients with aortic stenosis

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Science Translational Medicine  11 Sep 2019:
Vol. 11, Issue 509, eaaw0181
DOI: 10.1126/scitranslmed.aaw0181

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Hard work meets the path of least resistance

Transcatheter aortic valve replacement (TAVR) is a treatment for patients with aortic stenosis (narrow aortic valve) that reduces the transvalvular pressure gradient; however, only some patients experience improved quality of life after the procedure. To understand how valvular, ventricular, and systemic vascular conditions contribute to improvements after TAVR, Ben-Assa et al. studied 70 patients undergoing the procedure. Patients with lower preprocedural vascular impedance and higher left ventricular stroke work had greater improvements in quality of life after TAVR. This suggests that analyzing valve, ventricle, and arterial system hemodynamics could identify patients likely to benefit from TAVR and inform timing of intervention.

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