{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:42:42Z","timestamp":1759333362866},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,9,11]],"date-time":"2012-09-11T00:00:00Z","timestamp":1347321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p>Background: We hypothesized that degenerative calcific aortic stenosis (<jats:styled-content style=\"fixed-case\">DCAS<\/jats:styled-content>) is a syndrome influenced by factors beyond aortic valve stenosis (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>). The aim of this study was to assess how frequently <jats:styled-content style=\"fixed-case\">DCAS<\/jats:styled-content> is complicated by increased vascular load, systolic and\/or diastolic left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) dysfunction, and comorbid disorders. Methods: In 215 consecutive patients\u00a0&gt;\u00a060\u00a0years of age with severe and moderate <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>, we analyzed systemic arterial compliance, global hemodynamic load, <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> ejection fraction (<jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>), the presence of diastolic dysfunction, and other valvular or systemic disorders. Results: A total of 164 patients had severe <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> and 51 had moderate <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>. In patients with severe <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>, the prevalence of increased vascular load was 42%; <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> systolic and diastolic dysfunction was present in 27% and 42%; other valve diseases in 23%; and comorbid disorders in 82%. In the moderate <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> group, abnormal vascular load was found in 52%; <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> systolic and diastolic dysfunction was prevalent in 26% and 31%; other valve diseases in 17%; and comorbid disorders in 78% patients. More than half the patients in both groups had symptoms. In both severe and moderate <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> groups, the prevalence of increased vascular load and systolic dysfunction was higher in the symptomatic group. Conclusion: Considerable number of patients with <jats:styled-content style=\"fixed-case\">DCAS<\/jats:styled-content> have abnormal vascular load, abnormal <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> function, and significant coexisting disorders. These could influence the total pathophysiologic burden on the heart and symptom expression. Thus, <jats:styled-content style=\"fixed-case\">DCAS<\/jats:styled-content> should not be considered just as valvular stenosis, but a syndrome of <jats:styled-content style=\"fixed-case\">DCAS<\/jats:styled-content> because of the diagnostic, prognostic, and therapeutic implications of various factors associated with it.<\/jats:p>","DOI":"10.1111\/j.1540-8175.2012.01799.x","type":"journal-article","created":{"date-parts":[[2012,9,11]],"date-time":"2012-09-11T09:41:26Z","timestamp":1347356486000},"page":"1-7","source":"Crossref","is-referenced-by-count":3,"title":["The Syndrome of Degenerative Calcific Aortic Stenosis: Prevalence of Multiple Pathophysiologic Disorders in Association with Valvular Stenosis and Their Implications"],"prefix":"10.1111","volume":"30","author":[{"given":"Alamelu","family":"Ramamurthi","sequence":"first","affiliation":[{"name":"Tufts Heart Valve Center Tufts Medical Center  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natesa G.","family":"Pandian","sequence":"additional","affiliation":[{"name":"Tufts Heart Valve Center Tufts Medical Center  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dakshin","family":"Gangadharamurthy","sequence":"additional","affiliation":[{"name":"Tufts Heart Valve Center Tufts Medical Center  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose A.","family":"Urbano\u2010Moral","sequence":"additional","affiliation":[{"name":"Tufts Heart Valve Center Tufts Medical Center  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey T.","family":"Kuvin","sequence":"additional","affiliation":[{"name":"Tufts Heart Valve Center Tufts Medical Center  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayan R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Tufts Heart Valve Center Tufts Medical Center  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew R.","family":"Weintraub","sequence":"additional","affiliation":[{"name":"Tufts Heart Valve Center Tufts Medical Center  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,9,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)61880-1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1076-7460.2007.07641.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2010.01363.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.10.081"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000070029.30058.59"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.668681"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.030601"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jeq014"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.098392"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.111914"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2008.12.021"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.69.5.855"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000051865.66123.B7"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1136\/hrt.2009.190942","article-title":"Risk stratification in asymptomatic moderate to severe aortic stenosis: The importance of the valvular, arterial and ventricular interplay","volume":"96","author":"Lancellotti P","journal-title":"Heart"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.58.2.255"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00563-3"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1161\/01.CIR.91.9.2353","article-title":"Normalization of diastolic dysfunction in aortic stenosis late after valve replacement","volume":"91","author":"Villari B","journal-title":"Circulation"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.847772"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.11.023"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.jacc.2009.04.079","article-title":"Usefulness of the valvuloarterial impedance to predict adverse outcome in asymptomatic aortic stenosis","volume":"54","author":"Hachicha Z","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jacc.2006.05.021","article-title":"ACC\/AHA 2006 guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons","volume":"48","author":"Bonow RO","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01759-X"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.03.002"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.08.008"},{"key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"3006","DOI":"10.1161\/01.CIR.0000047200.36165.B8","article-title":"Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: First human case description","volume":"106","author":"Cribier A","journal-title":"Circulation"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.698258"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.95.9.2262"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.07.046"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2009.181982"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.072"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.62.1.42"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.757427"},{"key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1161\/01.CIR.95.10.2395","article-title":"Aortic valve replacement for aortic stenosis with severe left ventricular dysfunction: Prognostic indicators","volume":"95","author":"Connolly HM","journal-title":"Circulation"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a015209"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.07.005"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2009.165548"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.495903"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200008313430903"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1540-8175.2012.01799.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1540-8175.2012.01799.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:18:20Z","timestamp":1700612300000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1540-8175.2012.01799.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9,11]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1111\/j.1540-8175.2012.01799.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1540-8175.2012.01799.x","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9,11]]}}}