Beyond Gradient, Beyond Flow: Rethinking Risk Stratification in Aortic Stenosis
Kimberley I. Hemelrijk, Hugo M. Aarts, Gijs M. Broeze, Astrid C. van Nieuwkerk, Ronak Delewi · 2026
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Description
Hemelrijk and co-authors reply in 2026 to comments on their study of aortic stenosis, a narrowed heart valve, in patients receiving a replacement valve through a catheter. Their reply revisits results from the CENTER2 dataset of 15,233 treated patients. The dispute concerns how doctors should judge risk when the usual measures disagree, a pattern called discordant stenosis, rather than relying on pressure gradient or flow alone.
One in five patients in the dataset had discordant measurements, the authors restate, yet overall death rates matched those of straightforward high-gradient cases. The exception was the subgroup with low pressure gradients plus a weak heart pump, who died more often within a year of treatment. Patients with low gradients but a preserved pump did as well as high-gradient patients, leading the authors to back broader risk staging that includes heart damage beyond the valve.
Catalog record
| CREATOR | Kimberley I. Hemelrijk, Hugo M. Aarts, Gijs M. Broeze, Astrid C. van Nieuwkerk, Ronak Delewi |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 4 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |