Para refletir em 2014: Área valvar na estenose com FE rebaixada

Aortic Valve Area, Stroke Volume, Left Ventricular Hypertrophy, Remodeling, and Fibrosis in Aortic Stenosis Assessed by Cardiac Magnetic Resonance Imaging
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By CMR, however, planimetric AVA(Valvar area) was larger in LF/LG (0.54±0.08 cm2/m2) and LG/NF (0.61±0.08 cm2/m2) than in HG/LF (0.46±0.07 cm2/m2; P<0.05) AS, and indexed LV mass was lower in LG/LF (75±12 g/m2) and LG/NF (81±18 g/m2) than in HG/LF (100±27 g/m2; P<0.05) AS
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CMR confirmed that classification of AS patterns by TTE was overall accurate. We observed a good correlation between measurements of LVOT, stroke volume, and aortic valve area between TTE and CMR.

Patients with paradoxical LG/LF and LG/NF AS had less severe AS severity, less hypertrophy and remodeling, and a similar amount of focal fibrosis compared with HG AS.
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E agora, senhores ecocardiografistas, como explicar os achados de área valvar superior na estenose aórtica com gradiente baixo????
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