BACKGROUND: Low mean transvalvular gradient (<40 mm  Hg) and small aortic valve area (<1.0 cm(2)) in @entity1 with @entity472 ( @entity472 ) and preserved left ventricular ejection fraction raises uncertainty about the actual severity of the stenosis and survival benefit of aortic valve replacement (AVR). OBJECTIVES: This study analyzed studies of mortality and survival impact of AVR in @entity1 with low-gradient (LG) @entity472 and preserved left ventricular ejection fraction, including paradoxical low-flow (i.e., @entity64 volume index  <35 ml/m(2)), low-gradient (LF-LG) and normal-flow, low-gradient (NF-LG), and those with high-gradient (>= 40 mm  Hg) @entity472 or moderate @entity472 . METHODS: Studies published between 2005 and 2015 were analyzed. Primary outcome was the survival benefit associated with AVR. Secondary outcome was overall mortality regardless of treatment. RESULTS: Eighteen studies were included in the analysis. @entity1 with LF-LG @entity472 have increased mortality compared with @entity1 with moderate @entity472 (hazard ratio [HR]: 1.68; 95% confidence interval [CI]: 1.31 to 2.17), NF-LG (HR: 1.80; 95% CI: 1.29 to 2.51), and high-gradient (HR: 1.67; 95% CI: 1.16 to 2.39) @entity472 . AVR was associated with reduced mortality in @entity1 with LF-LG (HR: 0.44; 95% CI: 0.25 to 0.77). Similar benefit occurred with AVR in @entity1 with NF-LG (HR:  0.48; 95% CI: 0.28 to 0.83). Compared with @entity1 with high-gradient @entity472 , those with LF-LG were less likely to be referred to AVR (odds ratio: 0.32; 95% CI: 0.21 to 0.49). CONCLUSIONS: @entity1 with paradoxical LF-LG @entity472 and NF-LG @entity472 have increased risk of mortality compared with  other subtypes of @entity472 with preserved left ventricular ejection fraction, and improved outcome with AVR.

Outcome and Impact of Aortic  Valve  Replacement in XXXX With  Preserved LVEF and Low-Gradient  Aortic Stenosis.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity472 :: ('MESH:D001024', 'Disease') :: ['AS', 'aortic stenosis'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke']
@entity1 :: (9606,Species) :: ['Patients']
