Evidence map›Paper›PMID 38204672›Full record

ArticleJTCVS open2023

The robustness of the flow-gradient classification of severe aortic stenosis.

Bart J J Velders, Michiel D Vriesendorp, Federico M Asch, Michael G Moront, Francois Dagenais, Michael J Reardon, Joseph F Sabik Iii, Rolf H H Groenwold, Robert J M Klautz

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Article in JTCVS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Bart J J VeldersCardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Michiel D VriesendorpCardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Federico M AschCardiovascular Core Laboratories, MedStar Health Research Institute, Georgetown University, Washington, DC.
Michael G MorontCardiothoracic Surgery, ProMedica Toledo Hospital, Toledo, Ohio.
Francois DagenaisCardiac Surgery, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada.
Michael J ReardonCardiovascular Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex.
Joseph F Sabik IiiSurgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio.
Rolf H H GroenwoldClinical Epidemiology & Biomedical Data Science, Leiden University Medical Center, Leiden, The Netherlands.
Robert J M KlautzCardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: A flow-gradient classification is used to determine the indication for intervention for patients with severe aortic stenosis (AS) with discordant echocardiographic parameters. We investigated the agreement in flow-gradient classification by stroke volume (SV) measurement at the left ventricular outflow tract (LVOT) and at the left ventricle. Methods: Data were used from a prospective cohort study and patients with severe AS (aortic valve area index ≤0.6 cm Results: Of 1118 patients, 699 were eligible. The group composition changed considerably as agreement on flow state occurred in only 50% of the measurements. LVOT SV was on average 15.1 mL (95% limits of agreement -24.9:55.1 mL) greater than volumetric SV. When a systematic 1-mm LVOT diameter overestimation was introduced, the low-flow groups halved. Conclusions: There was poor agreement in the flow-gradient classification of severe AS as a result of large differences between LVOT and volumetric SV. Furthermore, this classification was sensitive to small measurement errors. These results stress that parameters beyond the flow-gradient classification should be considered to ensure accurate recommendations for intervention.

Indexed as

flow-gradient classificationlow flowsevere aortic stenosisstroke volume

Identifiers

PMID38204672
PMCPMC10775038

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.