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Elevated aortic transvalvular pressure gradient

MedGen UID:
1053075
•Concept ID:
CN376739
•
Finding
HPO: HP:6000226

Definition

The gradient (in this case, drop) in pressure across the aortic valve is above the upper limit of normal. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVElevated aortic transvalvular pressure gradient

Professional guidelines

PubMed

Management of aortic insufficiency in the continuous flow left ventricular assist device population.
Holtz J, Teuteberg J
Curr Heart Fail Rep 2014 Mar;11(1):103-10. doi: 10.1007/s11897-013-0172-6. PMID: 24193452

Recent clinical studies

Etiology

Moderate aortic stenosis: Navigating the uncharted.
Caprio MV, De Donno F, Bisaccia G, Mantini C, Di Baldassarre A, Gallina S, Khanji MY, Ricci F
Echocardiography 2024 Jun;41(6):e15859. doi: 10.1111/echo.15859. PMID: 38853624
Transvalvular Pressure Gradients and All-Cause Mortality Following TAVR: A Multicenter Echocardiographic and Invasive Registry.
Khalili H, Pibarot P, Hahn RT, Elmariah S, Pilgrim T, Bavry AA, Maini B, Okuno T, Al-Azizi K, Waggoner TE, Mack M, Rodès-Cabau J, Abbas AE
JACC Cardiovasc Interv 2022 Sep 26;15(18):1837-1848. doi: 10.1016/j.jcin.2022.07.033. PMID: 36137687
Comparison of Transvalvular Aortic Mean Gradients Obtained by Intraprocedural Echocardiography and Invasive Measurement in Balloon and Self-Expanding Transcatheter Valves.
Abbas AE, Mando R, Kadri A, Khalili H, Hanzel G, Shannon F, Al-Azizi K, Waggoner T, Kassas S, Pilgrim T, Okuno T, Camacho A, Selberg A, Elmariah S, Bavry A, Ternacle J, Christensen J, Gheewala N, Pibarot P, Mack M
J Am Heart Assoc 2021 Oct 5;10(19):e021014. Epub 2021 Sep 29 doi: 10.1161/JAHA.120.021014. PMID: 34585593Free PMC Article
Prognostic value of the H(2) FPEF score in patients undergoing transcatheter aortic valve implantation.
Ludwig S, Pellegrini C, Gossling A, Rheude T, Voigtländer L, Bhadra OD, Linder M, Kalbacher D, Koell B, Waldschmidt L, Schirmer J, Seiffert M, Reichenspurner H, Blankenberg S, Westermann D, Conradi L, Joner M, Schofer N
ESC Heart Fail 2021 Feb;8(1):461-470. Epub 2020 Nov 20 doi: 10.1002/ehf2.13096. PMID: 33215870Free PMC Article
Differences in natural history of low- and high-gradient aortic stenosis from nonsevere to severe stage of the disease.
Herrmann S, Fries B, Liu D, Hu K, Stoerk S, Voelker W, Ruppert C, Lorenz K, Ertl G, Weidemann F
J Am Soc Echocardiogr 2015 Nov;28(11):1270-1282.e4. Epub 2015 Aug 28 doi: 10.1016/j.echo.2015.07.016. PMID: 26321001

Diagnosis

Moderate aortic stenosis: Navigating the uncharted.
Caprio MV, De Donno F, Bisaccia G, Mantini C, Di Baldassarre A, Gallina S, Khanji MY, Ricci F
Echocardiography 2024 Jun;41(6):e15859. doi: 10.1111/echo.15859. PMID: 38853624
Echocardiographic Versus Invasive Aortic Valve Gradients in Different Clinical Scenarios.
Abbas AE, Khalili H, Madanat L, Elmariah S, Shannon F, Al-Azizi K, Waggoner T, Pilgrim T, Okuno T, Bavry A, Ternacle J, Christensen J, Cabau JR, Mack M, Pibarot P
J Am Soc Echocardiogr 2023 Dec;36(12):1302-1314. Epub 2023 Jul 26 doi: 10.1016/j.echo.2023.06.016. PMID: 37507058
Cine-Computed Tomography for the Evaluation of Prosthetic Heart Valve Function.
Hsu C, Bourganos K, Zafar MA, Huber S, Buntin J, Ziganshin BA, Mojibian H, Elefteriades JA
Cardiology 2020;145(7):439-445. Epub 2020 May 26 doi: 10.1159/000507182. PMID: 32454507
Differences in natural history of low- and high-gradient aortic stenosis from nonsevere to severe stage of the disease.
Herrmann S, Fries B, Liu D, Hu K, Stoerk S, Voelker W, Ruppert C, Lorenz K, Ertl G, Weidemann F
J Am Soc Echocardiogr 2015 Nov;28(11):1270-1282.e4. Epub 2015 Aug 28 doi: 10.1016/j.echo.2015.07.016. PMID: 26321001
Management of aortic insufficiency in the continuous flow left ventricular assist device population.
Holtz J, Teuteberg J
Curr Heart Fail Rep 2014 Mar;11(1):103-10. doi: 10.1007/s11897-013-0172-6. PMID: 24193452

Therapy

Moderate aortic stenosis: Navigating the uncharted.
Caprio MV, De Donno F, Bisaccia G, Mantini C, Di Baldassarre A, Gallina S, Khanji MY, Ricci F
Echocardiography 2024 Jun;41(6):e15859. doi: 10.1111/echo.15859. PMID: 38853624
Elevated Prosthetic Valve Gradients: What to Consider When Determining an Etiology.
Dietrich M, Mankad R
J Cardiothorac Vasc Anesth 2021 Jul;35(7):2223-2227. Epub 2021 Feb 12 doi: 10.1053/j.jvca.2021.02.021. PMID: 33744112
Cine-Computed Tomography for the Evaluation of Prosthetic Heart Valve Function.
Hsu C, Bourganos K, Zafar MA, Huber S, Buntin J, Ziganshin BA, Mojibian H, Elefteriades JA
Cardiology 2020;145(7):439-445. Epub 2020 May 26 doi: 10.1159/000507182. PMID: 32454507
Management of aortic insufficiency in the continuous flow left ventricular assist device population.
Holtz J, Teuteberg J
Curr Heart Fail Rep 2014 Mar;11(1):103-10. doi: 10.1007/s11897-013-0172-6. PMID: 24193452
Pitfalls in interpreting bioprosthetic aortic valve pressure gradients: a cautionary tale!
Buchholz S, Robaei D, Jacobs NH, Feneley MP
Echocardiography 2012 Oct;29(9):E218-20. Epub 2012 Jul 2 doi: 10.1111/j.1540-8175.2012.01775.x. PMID: 22747659

Prognosis

Fluid-structure interaction analysis of eccentricity and leaflet rigidity on thrombosis biomarkers in bioprosthetic aortic valve replacements.
Oks D, Samaniego C, Houzeaux G, Butakoff C, Vázquez M
Int J Numer Method Biomed Eng 2022 Dec;38(12):e3649. Epub 2022 Oct 11 doi: 10.1002/cnm.3649. PMID: 36106918
Comparison of Transvalvular Aortic Mean Gradients Obtained by Intraprocedural Echocardiography and Invasive Measurement in Balloon and Self-Expanding Transcatheter Valves.
Abbas AE, Mando R, Kadri A, Khalili H, Hanzel G, Shannon F, Al-Azizi K, Waggoner T, Kassas S, Pilgrim T, Okuno T, Camacho A, Selberg A, Elmariah S, Bavry A, Ternacle J, Christensen J, Gheewala N, Pibarot P, Mack M
J Am Heart Assoc 2021 Oct 5;10(19):e021014. Epub 2021 Sep 29 doi: 10.1161/JAHA.120.021014. PMID: 34585593Free PMC Article
Prognostic value of the H(2) FPEF score in patients undergoing transcatheter aortic valve implantation.
Ludwig S, Pellegrini C, Gossling A, Rheude T, Voigtländer L, Bhadra OD, Linder M, Kalbacher D, Koell B, Waldschmidt L, Schirmer J, Seiffert M, Reichenspurner H, Blankenberg S, Westermann D, Conradi L, Joner M, Schofer N
ESC Heart Fail 2021 Feb;8(1):461-470. Epub 2020 Nov 20 doi: 10.1002/ehf2.13096. PMID: 33215870Free PMC Article
Assessment of trans-aortic pressure gradient using a coronary pressure wire in patients with mechanical aortic and mitral valve prostheses.
Kherada N, Brenes JC, Kini AS, Dangas GD
Catheter Cardiovasc Interv 2018 Jul;92(1):193-199. Epub 2017 Mar 15 doi: 10.1002/ccd.26962. PMID: 28296135
Management of aortic insufficiency in the continuous flow left ventricular assist device population.
Holtz J, Teuteberg J
Curr Heart Fail Rep 2014 Mar;11(1):103-10. doi: 10.1007/s11897-013-0172-6. PMID: 24193452

Clinical prediction guides

Moderate aortic stenosis: Navigating the uncharted.
Caprio MV, De Donno F, Bisaccia G, Mantini C, Di Baldassarre A, Gallina S, Khanji MY, Ricci F
Echocardiography 2024 Jun;41(6):e15859. doi: 10.1111/echo.15859. PMID: 38853624
Transvalvular Pressure Gradients and All-Cause Mortality Following TAVR: A Multicenter Echocardiographic and Invasive Registry.
Khalili H, Pibarot P, Hahn RT, Elmariah S, Pilgrim T, Bavry AA, Maini B, Okuno T, Al-Azizi K, Waggoner TE, Mack M, Rodès-Cabau J, Abbas AE
JACC Cardiovasc Interv 2022 Sep 26;15(18):1837-1848. doi: 10.1016/j.jcin.2022.07.033. PMID: 36137687
Comparison of Transvalvular Aortic Mean Gradients Obtained by Intraprocedural Echocardiography and Invasive Measurement in Balloon and Self-Expanding Transcatheter Valves.
Abbas AE, Mando R, Kadri A, Khalili H, Hanzel G, Shannon F, Al-Azizi K, Waggoner T, Kassas S, Pilgrim T, Okuno T, Camacho A, Selberg A, Elmariah S, Bavry A, Ternacle J, Christensen J, Gheewala N, Pibarot P, Mack M
J Am Heart Assoc 2021 Oct 5;10(19):e021014. Epub 2021 Sep 29 doi: 10.1161/JAHA.120.021014. PMID: 34585593Free PMC Article
Assessment of trans-aortic pressure gradient using a coronary pressure wire in patients with mechanical aortic and mitral valve prostheses.
Kherada N, Brenes JC, Kini AS, Dangas GD
Catheter Cardiovasc Interv 2018 Jul;92(1):193-199. Epub 2017 Mar 15 doi: 10.1002/ccd.26962. PMID: 28296135
Hemodynamic and clinical impact of prosthesis-patient mismatch after transcatheter aortic valve implantation.
Ewe SH, Muratori M, Delgado V, Pepi M, Tamborini G, Fusini L, Klautz RJ, Gripari P, Bax JJ, Fusari M, Schalij MJ, Marsan NA
J Am Coll Cardiol 2011 Oct 25;58(18):1910-8. Epub 2011 Oct 6 doi: 10.1016/j.jacc.2011.08.027. PMID: 21982276

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