title: Can severity of aortic stenosis be determined despite absent contractile reserve in low-flow low-gradient aortic stenosis?
abstract: A 79-year-old man presented with increasing breathlessness and his echocardiogram revealed severe left ventricular systolic dysfunction and low-flow low-gradient aortic stenosis. Low-dose dobutamine stress echocardiography revealed the absence of contractile reserve (increase of stroke volume by ≥20% did not occur). The test would have therefore been inconclusive. However, the attainment of normal flow (FR≥200 mL/s) during dobutamine stress enabled the diagnosis of true severe aortic stenosis.
authors: Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, United Kingdom.
authors: Anastasia
authors: A
authors: Vamvakidou
authors: Wessex Cardiothoracic Centre, University Hospital Southampton, London, United Kingdom.
authors: Benoy N
authors: BN
authors: Shah
authors: Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, United Kingdom. roxysenior@cardiac-research.org.|Department of Cardiology, Royal Brompton Hospital, London, United Kingdom. roxysenior@cardiac-research.org.|Cardiovascular Biomedical Research Unit, National Heart and Lung Institute, Imperial College, London, United Kingdom. roxysenior@cardiac-research.org.
authors: Roxy
authors: R
authors: Senior
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D025401:Echocardiography, Stress / Q000379:methods*; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D012720:Severity of Illness Index
keywords: aortic stenosis; low-flow low-gradient stress echocardiography