Systemic hypertension in low-gradient severe aortic stenosis with preserved ejection fraction

  • Eleid M
  • Nishimura R
  • Sorajja P
 et al. 
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Abstract

BACKGROUND-: Low-gradient severe aortic stenosis with preserved ejection fraction is an increasingly recognized entity, and symptomatic patients may benefit from aortic valve replacement. However, systemic hypertension frequently coexists with low-gradient severe aortic stenosis, which itself may cause elevated left ventricular (LV) filling pressures with resultant symptoms of dyspnea. METHODS AND RESULTS-: Symptomatic patients with hypertension (aortic systolic pressure >140 mm Hg) and low-gradient (mean gradient 50%) who underwent invasive hemodynamic catheterization of the left and right sides of the heart received infusion of intravenous sodium nitroprusside to reduce blood pressure and arterial afterload. At baseline, patients had severe hypertension (aortic systolic pressure, 176+/-26 mm Hg), pulmonary hypertension (mean pressure, 39+/-12 mm Hg), elevated LV end-diastolic pressure (19+/-5 mm Hg), and reduced stroke volume (33+/-8 mL/m). All measures of afterload were reduced with nitroprusside (P

Author-supplied keywords

  • Aortic Valve
  • Arteries
  • Blood Pressure
  • Cental2014Iss1
  • Dyspnea
  • Heart
  • Hypertension
  • Methods
  • Nitroprusside
  • Patients
  • Pressure
  • Pulmonary Artery
  • Sodium
  • Stroke
  • Stroke Volume
  • Symptom
  • Therapy
  • aged .Therapy .Drug Therapy .Drug Therapy .Drug Th

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Authors

  • M F Eleid

  • R A Nishimura

  • P Sorajja

  • B A Borlaug

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