Low Flow Low Gradient Aortic Stenosis Relevance of the (re)Search for a Contractile Reserve

Low Flow Low Gradient Aortic Stenosis Relevance of the (re)Search for a Contractile Reserve

Investigators sought to demonstrate that the increase in the stroke volume during a dobutamine stress echocardiography might impact the prognosis of a patient addressed for a low flow low gradient suspected severe aortic valve stenosis.

Inclusion Criteria:

• Patient from 45 to 90 years old
• Patient agreeing freely to participate in the study
• Aortic surface area suspected to be < 1 cm² or < 0.6 cms²/m²
• Low aortic gradient defined by a mean pressure gradient < 40 mmHg
• Aortic low flow defined by: a stroke volume indexed < 35 ml/m2
• Any contra-indication for the realization of the MRI

Exclusion Criteria:

• Heart rhythm disorders
• Presence of comorbidity altering the 2-year prognosis of a patient (cancer, terminal renal insufficiency (GFR 30 ml / min / 1,73m2), liver cirrhosis, respiratory insufficiency (VEMS 1 L)
• Presence of a concomitant valvular heart disease with stenosis or regurgitation > moderated
• Persons subject to major legal protection (safeguarding justice, guardianship, trusteeship), persons deprived of liberty