{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T16:43:42Z","timestamp":1777308222304,"version":"3.51.4"},"reference-count":6,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"abstract":"<jats:p>Introduction: The definition of low-flow\/low-gradient aortic stenosis (AS) using the stroke volume index (SVI) alone overlooks factors like vascular resistance and valve stiffness. Consequently, an SVI indicating a normal flow might indicate a low flow when used with the transvalvular flow rate (TFR), which incorporates ejection time. We compared the SVI (35 mL\/m2) and TFR (250 mL\/m2) and analyzed the outcomes for patients with and without aortic valve replacement (AVR). Methods: From 2013 to 2016, we retrospectively evaluated the clinical data of patients with moderate-to-severe and severe AS, defined as a maximum aortic valve velocity \u22653.5 m\/s or a valve area \u22641.3 cm2. Patients were categorized into AVR and non-AVR groups. The non-AVR group was further classified by a TFR above or below 250 mL\/m2. Moreover, we compared the SVIs with TFRs. We examined the rates of all-cause mortality and heart failure hospitalizations. Results: Among 135 patients, 42 (31%) had mismatched SVIs and TFRs; 41 had a high SVI and a low TFR, whereas one had a low SVI and a high TFR. Among the 59 non-AVR patients, 25 (71.4%) of the 35 patients with a low TFR died, whereas 4 (16.7%) of the 24 patients with a high TFR died. The TFR in the 76 AVR patients was similar to that in the non-AVR patients, 3 of whom died (3.9%). The Kaplan-Meier analysis revealed that non-AVR patients with a low TFR had worse outcomes and the AVR patients fared best. The SVI was significantly less suitable than the TFR for risk stratification. Conclusion: This study highlights that a high TFR, rather than a high SVI, is associated with a better prognosis, even among non-AVR patients, suggesting that the TFR is better for risk assessment and complements the SVI.<\/jats:p>","DOI":"10.1159\/000544784","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T12:00:35Z","timestamp":1739793635000},"page":"236-241","source":"Crossref","is-referenced-by-count":0,"title":["Transvalvular Flow Rates in Patients with Moderate-To-Severe and Severe Aortic Stenosis: Clinical Usefulness and Risk Stratification"],"prefix":"10.1159","volume":"151","author":[{"given":"Hyungseop","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In-Cheol","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee-Jeong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.075853"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.01.002"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2020.12.029"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2021.08.016"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.02.046"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.04.021"}],"container-title":["Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/crd\/article-pdf\/doi\/10.1159\/000544784\/4340001\/000544784.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000544784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T16:02:37Z","timestamp":1777305757000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000544784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,17]]},"references-count":6,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,27]]},"published-print":{"date-parts":[[2026,5,6]]}},"URL":"https:\/\/doi.org\/10.1159\/000544784","archive":["Portico"],"relation":{},"ISSN":["0008-6312","1421-9751"],"issn-type":[{"value":"0008-6312","type":"print"},{"value":"1421-9751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,17]]}}}