{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:35:20Z","timestamp":1790836520313,"version":"4.1.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Concerns about discordance between echocardiographic and invasive mean gradients after transcatheter aortic valve replacement (TAVR) with balloon\u2010expandable valves (BEVs) versus self\u2010expanding valves (SEVs) exist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In a multicenter study, direct\u2010invasive and echocardiography\u2010derived transvalvular mean gradients obtained before and after TAVR were compared as well as post\u2010TAVR and discharge echocardiographic mean gradients in BEVs versus SEVs in 808 patients. Pre\u2010TAVR, there was good correlation (\n                      <jats:italic>R<\/jats:italic>\n                      =0.614;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) between direct\u2010invasive and echocardiography\u2010derived mean gradients and weak correlation (\n                      <jats:italic>R<\/jats:italic>\n                      =0.138;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) post\u2010TAVR. Compared with post\u2010TAVR echocardiographic mean gradients, both valves exhibit lower invasive and higher discharge echocardiographic mean gradients. Despite similar invasive mean gradients, a small BEV exhibits higher post\u2010TAVR and discharge echocardiographic mean gradients than a large BEV, whereas small and large SEVs exhibit similar post\u2010TAVR and discharge mean gradients. An ejection fraction &lt;50% (\n                      <jats:italic>P<\/jats:italic>\n                      =0.028) and higher Society of Thoracic Surgeons predicted risk of mortality score (\n                      <jats:italic>P<\/jats:italic>\n                      =0.007), but not invasive or echocardiographic mean gradient \u226510\u00a0mm\u00a0Hg (\n                      <jats:italic>P<\/jats:italic>\n                      =0.378 and\n                      <jats:italic>P<\/jats:italic>\n                      =0.341, respectively), nor discharge echocardiographic mean gradient \u226520\u00a0mm\u00a0Hg (\n                      <jats:italic>P<\/jats:italic>\n                      =0.393), were associated with increased 2\u2010year mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Invasively measured and echocardiography\u2010derived transvalvular mean gradients correlate well in aortic stenosis but weakly post\u2010TAVR. Post\u2010TAVR, echocardiography overestimates transvalvular mean gradients compared with invasive measurements, and poor correlation suggests these modalities cannot be used interchangeably. Moreover, echocardiographic mean gradients are higher on discharge than post\u2010TAVR in all valves. Despite similar invasive mean gradients, a small BEV exhibits higher post\u2010TAVR and discharge echocardiographic mean gradients than a large BEV, whereas small and large SEVs exhibit similar post\u2010TAVR and discharge mean gradients. Immediately post\u2010TAVR, elevated echocardiographic\u2010derived mean gradients should be assessed with caution and compared with direct\u2010invasive mean gradients. A low ejection fraction and higher Society of Thoracic Surgeons score, but not elevated mean gradients, are associated with increased 2\u2010year mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.021014","type":"journal-article","created":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T05:29:06Z","timestamp":1632893346000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":68,"title":["Comparison of Transvalvular Aortic Mean Gradients Obtained by Intraprocedural Echocardiography and Invasive Measurement in Balloon and Self\u2010Expanding Transcatheter Valves"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7316-4247","authenticated-orcid":false,"given":"Amr E.","family":"Abbas","sequence":"first","affiliation":[{"name":"Beaumont Hospital Royal Oak Royal Oak MI"},{"name":"Oakland University William Beaumont School of Medicine Auburn Hills 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