{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:13:50Z","timestamp":1792422830487,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">In view of the rising global burden of severe symptomatic aortic stenosis, its early recognition and treatment is key. Although patients with classical low\u2010flow, low\u2010gradient (C\u2010LFLG) aortic stenosis have higher rates of death after transcatheter aortic valve implantation (TAVI) when compared with patients with high\u2010gradient (HG) aortic stenosis, there is conflicting evidence on the death rate in patients with severe paradoxical low\u2010flow, low\u2010gradient (P\u2010LFLG) aortic stenosis. Therefore, we aimed to compare outcomes in real\u2010world patients with severe HG, C\u2010LFLG, and P\u2010LFLG aortic stenosis undergoing TAVI.<\/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                      Clinical outcomes up to 5\u2009years were addressed in the 3 groups of patients enrolled in the prospective, national, multicenter SwissTAVI registry. A total of 8914 patients undergoing TAVI at 15 heart valve centers in Switzerland were analyzed for the purpose of this study. We observed a significant difference in time to death at 1\u2009year after TAVI, with the lowest observed in HG (8.8%) aortic stenosis, followed by P\u2010LFLG (11.5%; hazard ratio [HR], 1.35 [95% CI, 1.16\u20131.56];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and C\u2010LFLG (19.8%; HR, 1.93 [95% CI, 1.64\u20132.26];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) aortic stenosis. Cardiovascular death showed similar differences between the groups. At 5\u2009years, the all\u2010cause death rate was 44.4% in HG, 52.1% in P\u2010LFLG (HR, 1.35 [95% CI, 1.23\u20131.48];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), and 62.8% in C\u2010LFLG aortic stenosis (HR, 1.7 [95% CI, 1.54\u20131.88];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Up to 5\u2009years after TAVI, patients with P\u2010LFLG have higher death rates than patients with HG aortic stenosis but lower death rates than patients with C\u2010LFLG aortic stenosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.029489","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T22:27:30Z","timestamp":1686436050000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Clinical Outcomes in High\u2010Gradient, Classical Low\u2010Flow, Low\u2010Gradient, and Paradoxical Low\u2010Flow, Low\u2010Gradient Aortic Stenosis After Transcatheter Aortic Valve Implantation: A Report From the SwissTAVI Registry"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7970-8989","authenticated-orcid":false,"given":"Max","family":"Wagener","sequence":"first","affiliation":[{"name":"University Hospital Basel, University of Basel Switzerland"},{"name":"University Hospital Galway, University of Galway 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