{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T01:52:48Z","timestamp":1787968368690,"version":"build-2784847793"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T00:00:00Z","timestamp":1675814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The prognostic impact of flow trajectories according to stroke volume index (SVi) and transvalvular flow rate (FR) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) remains poorly assessed. We evaluated and compared SVi and FR prior and after TAVR for severe AS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Patients were categorized according to SVi (&amp;lt;35 mL\/m2) and FR (&amp;lt;200 mL\/s). The association of pre- and post-TAVR SVi and FR with all-cause mortality up to 3 years was assessed with multivariable Cox regression models. Among 980 patients with pre-TAVR flow assessment, SVi was reduced in 41.3% and FR in 48.1%. Baseline flow status was not an independent mortality predictor [SVi: hazard ratio (HR) 1.22, 95% confidence interval (CI) 0.85\u20131.82, FR: HR 0.78, 95% CI 0.48\u20131.27]. Among 731 patients undergoing early (5 days, interquartile range 2\u201329) post-TAVR flow assessment, SVi recovered in 40.1% and FR in 49.0% patients with baseline low flow. Reduced FR following TAVR was an independent predictor of mortality (HR 1.67, 95% CI 1.02\u20132.74), whereas SVi was not (HR 0.97, 95% CI 0.53\u20131.78). Three-year estimated mortality in patients with recovered FR was lower than that in patients with reduced FR (13.3 vs. 37.7% vs, P = 0.003) and similar to that in patients with normal baseline FR (P = 0.317).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Baseline flow status was not an independent predictor of mid-term mortality among all-comers with severe AS undergoing TAVR. Flow recovery early after TAVR was frequent. Post-TAVR FR, but not SVi, was independently associated with mid-term all-cause mortality. By impacting flow status, AV replacement modifies the association of flow status with outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead018","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T09:22:11Z","timestamp":1675848131000},"page":"1052-1061","source":"Crossref","is-referenced-by-count":11,"title":["Stroke volume index and transvalvular flow rate trajectories in severe aortic stenosis treated with TAVR"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-6844","authenticated-orcid":false,"given":"Guglielmo","family":"Gallone","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medical Sciences, Citt\u00e0 della Salute e della Scienza, University of Turin , Corso Bramante 88, 10121 Turin , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Islas","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IDISSC, and Universidad Complutense de Madrid , Calle del Prof Mart\u00edn Lagos, S\/N, 28040 Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-5289","authenticated-orcid":false,"given":"Riccardo","family":"Gorla","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato , Piazza Edmondo Malan, 2, 20097 San Donato Milanese, Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2159-1359","authenticated-orcid":false,"given":"Francesco","family":"Melillo","sequence":"additional","affiliation":[{"name":"Interventional Cardiology and Echocardiography Units, IRCCS San Raffaele Hospital , Via Olgettina, 60, 20132 Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Pasquale","family":"Leone","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University , Via Rita Levi Montalcini, 4, 20072 Pieve Emanuele-Milan , Italy"},{"name":"Cardio Center, IRCCS Humanitas Research Hospital , Via Alessandro Manzoni, 56, 20089 Rozzano, Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-7663","authenticated-orcid":false,"given":"Paolo","family":"Cimaglia","sequence":"additional","affiliation":[{"name":"GVM Care and Research Maria Cecilia Hospital , Via Corriera, 1, 48033 Cotignola, Ravenna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7223-141X","authenticated-orcid":false,"given":"Maria Concetta","family":"Pastore","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Azienda Ospedaliero Universitaria \"Maggiore Della Carita\" , L.go Bellini, 28100 Novara , Italy"},{"name":"Department of Translational Medicine, University of Eastern Piedmont , Via Solaroli 17, 28100 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