{"doi":"10.1097/hco.0b013e32801466f5","title":"Low-flow, low-gradient aortic stenosis: from evaluation to treatment","abstract":null,"journal":"Current Opinion in Cardiology","year":2007,"id":618445,"datarank":0.5456379239589579,"base_score":3.6375861597263857,"endowment":3.6375861597263857,"self_citation_contribution":0.5456379239589579,"citation_network_contribution":0.0,"self_endowment_contribution":0.5456379239589579,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":37,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1595462,"name":"Ian G Burwash","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Low-flow, low-gradient aortic stenosis: from evaluation to treatment","abstract":"PURPOSE OF REVIEW: Valve replacement improves symptoms and survival in symptomatic severe aortic stenosis. Low-flow, low-gradient aortic stenosis, however, is an especially challenging subset as valve replacement has a significant risk, and may fail to alleviate symptoms or improve left ventricular function. This article reviews the potential problems in evaluating aortic stenosis severity in low-flow, low-gradient aortic stenosis, the utility of dobutamine challenge to identify patients most likely to benefit from surgery, and the factors predicting patient outcome. RECENT FINDINGS: Low-flow, low-gradient aortic stenosis consists of a heterogeneous group of patients with 'true' severe aortic stenosis, in whom afterload mismatch results from a severely stenotic valve; and 'pseudo-severe' aortic stenosis, where the valve is only mildly or moderately stenotic, but appears severe due to limitations in determining disease severity under low-flow conditions. Valve replacement is likely to benefit the former group, but may have little benefit to the latter. Dobutamine challenge can distinguish 'true' and 'pseudo-severe' aortic stenosis, and can evaluate contractile reserve, one of the strongest predictors of patient outcome. Strategies to avoid prosthesis-patient mismatch should be considered to optimize postoperative outcome. SUMMARY: Dobutamine challenge can identify low-flow, low-gradient aortic stenosis patients most likely to benefit from valve replacement and provides important prognostic information on the operative risks and long-term outcome.","is_dataset_classified":null,"base_score":3.6375861597263857,"endowment":3.6375861597263857,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"17284985","pmcid":null,"openalex_id":"https://openalex.org/W2033365786","authors":[],"funders":[],"total_grants":0,"fwci":2.2733,"citation_percentile":0.88575801,"influential_citations":0,"citation_trend":[{"year":2012,"count":4},{"year":2013,"count":3},{"year":2014,"count":3},{"year":2015,"count":5},{"year":2018,"count":1},{"year":2019,"count":3},{"year":2022,"count":1},{"year":2026,"count":1}],"oa_status":"closed","license":null,"oa_locations":[{"url":"https://journals.lww.com/10.1097/HCO.0b013e32801466f5","host_type":"publisher"},{"url":"https://doi.org/10.1097/hco.0b013e32801466f5","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/17284985","host_type":"repository"}],"fields_of_study":["Cardiac Valve Diseases and Treatments","Aortic Disease and Treatment Approaches","Congenital Heart Disease Studies","Aortic Valve Stenosis","Blood Flow Velocity","Echocardiography, Stress","Heart Valve Prosthesis Implantation","Humans","Prognosis","Regional Blood Flow","Severity of Illness Index","Stroke Volume","Ventricular Dysfunction, Left"],"mesh_terms":["Aortic Valve Stenosis","Blood Flow Velocity","Humans","Prognosis","Regional Blood Flow","Severity of Illness Index","Stroke Volume","Ventricular Dysfunction, Left","Heart Valve Prosthesis Implantation","Echocardiography, Stress"],"keywords":["Medicine","Stenosis","Cardiology","Aortic valve replacement","Internal medicine","Aortic valve stenosis","Dobutamine","Valve replacement","Afterload","Aortic valve","Radiology","Hemodynamics"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T04:26:12.265410Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}