{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T20:31:04Z","timestamp":1775766664350,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"MSP Singapore Company"},{"name":"LLC, Singapore"},{"DOI":"10.13039\/100004334","name":"Merck & Co., Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Schering-Plough Corporation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Sex-specific low flow was recently defined as stroke volume index (SVi) \u2264 40\u2005mL\/m\u00b2 in men and \u226432\u2005mL\/m\u00b2 in women. We tested the prognostic association of these cut-offs in patients with aortic stenosis (AS) with concordantly and discordantly graded AS [concordantly graded AS by energy loss (CGASEL) and discordantly graded AS by energy loss (DGASEL)] based on pressure recovery adjusted aortic valve area [energy loss (EL)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Data from 1351 patients with asymptomatic AS, peak jet velocity &amp;lt;4\u2005m\/s, and preserved left ventricular ejection fraction enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study were used. DGASEL was defined as EL &amp;lt;1.0\u2005cm\u00b2 with mean aortic gradient &amp;lt;40\u2005mmHg and CGASEL as EL \u22651.0\u2005cm\u00b2 with mean aortic gradient &amp;lt;40\u2005mmHg. Patients were further grouped into normal and low flow. The outcome was combined all-cause death and hospitalization for heart failure (HF). CGASEL with normal\/low flow was present in 915\/253 patients, and DGASEL with normal\/low flow was present in 57\/126 patients. During a median follow-up of 4.3 years, event-free survival was lower in patients with DGASEL irrespective of flow compared to CGASEL with normal flow (P &amp;lt; 0.05). In Cox regression analysis, DGASEL with normal or low flow were both associated with increased risk of all-cause death and hospitalization for HF after adjustment for age, sex, heart rate, randomized study treatment, hypertension, aortic valve replacement, and aortic valve calcification (P &amp;lt; 0.05). No survival difference was found between patients with normal vs. low flow within groups of DGASEL or CGASEL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Identification of low flow by the proposed sex-specific thresholds of SVi needs more prognostic validation before application in clinical practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>ClinicalTrials.gov identifier<\/jats:title>\n                  <jats:p>NCT00092677.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeae272","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T21:37:01Z","timestamp":1730151421000},"page":"280-286","source":"Crossref","is-referenced-by-count":2,"title":["Impact of sex-specific thresholds for low flow in assessment of prognosis in concordantly and discordantly graded aortic valve stenosis"],"prefix":"10.1093","volume":"26","author":[{"given":"Edda","family":"Bahlmann","sequence":"first","affiliation":[{"name":"Department of Cardiology, Asklepios Clinic St. Georg , Lohm\u00fchlenstrasse 5, Hamburg 20099 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4109-2311","authenticated-orcid":false,"given":"Eva","family":"Gerdts","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen , Bergen ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eigir","family":"Einarsen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nordland Hospital Trust, Vester\u00e5len Hospital , Stokmarknes ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helga","family":"Midtb\u00f8","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen , Bergen ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva R","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen , Bergen ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Rosseb\u00f8","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital , Ullev\u00e5l, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asklepios Clinic St. Georg , Lohm\u00fchlenstrasse 5, Hamburg 20099 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Cramariuc","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen , Bergen ,","place":["Norway"]},{"name":"Department of Heart Disease, 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