{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:51:49Z","timestamp":1790290309214,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,11,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Whether the presence of right ventricular (RV) dysfunction may influence the clinical outcome of patients with low\u2010flow, low\u2010gradient aortic stenosis (LFLG\u2010AS) undergoing transcatheter aortic valve replacement (TAVR) has not yet been established.<\/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\">This study included consecutive patients with LFLG\u2010AS undergoing TAVR at 2 high\u2010volume Italian centers. RV dysfunction before TAVR procedure was defined as tricuspid annular plane systolic excursion assessed by transthoracic echocardiography lower than &lt;17\u2009mm. The primary outcome was all\u2010cause death at 1\u2009year. The propensity score weighting technique was implemented to account for potential selection bias between patients with and without RV dysfunction. A prespecified subgroup analysis was conducted to evaluate the consistency of the results in patients with classical and paradoxical LFLG\u2010AS forms. This study included 392 patients; of them, 97 (24.7%) patients showed RV dysfunction before TAVR. At propensity score\u2013weighted adjusted Cox regression analysis, RV dysfunction, according to dichotomous definition, was associated with an increased risk for the primary outcome (adjusted hazard ratio [HR], 3.11 [95% CI, 1.58\u20136.13]), cardiovascular death (adjusted HR, 3.26 [95% CI, 1.58\u20136.72]), and major adverse cardiovascular and cerebrovascular events (adjusted HR, 3.39 [95% CI, 1.76\u20136.53]). Conversely, no difference was detected for the risk of stroke and of permanent pacemaker implantation. No significant interaction of the classical and paradoxical LFLG\u2010AS subgroups was detected for all the outcomes of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study suggests that RV dysfunction echocardiographically assessed by tricuspid annular plane systolic excursion may improve the prognostic stratification of patients with LFLG\u2010AS undergoing TAVR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.036239","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T05:48:00Z","timestamp":1730699280000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence and Prognostic Significance of Right Ventricular Dysfunction in Patients With Severe Low\u2010Flow, Low\u2010Gradient Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-7782","authenticated-orcid":false,"given":"Michele","family":"Bellino","sequence":"first","affiliation":[{"name":"University of Salerno","place":["Baronissi, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-6321","authenticated-orcid":false,"given":"Germano Junior","family":"Ferruzzi","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Baronissi, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5467-8736","authenticated-orcid":false,"given":"Arturo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Pineta Grande Hospital","place":["Castel Volturno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2864-2756","authenticated-orcid":false,"given":"Tiziana","family":"Attisano","sequence":"additional","affiliation":[{"name":"University Hospital San Giovanni di Dio e Ruggi d\u2019Aragona","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0300-594X","authenticated-orcid":false,"given":"Francesco","family":"Maiellaro","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Baronissi, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7796-6298","authenticated-orcid":false,"given":"Rodolfo","family":"Citro","sequence":"additional","affiliation":[{"name":"University of Molise","place":["Campobasso, 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Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4270-932X","authenticated-orcid":false,"given":"Sara","family":"Turino","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Baronissi, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Di Maio","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Baronissi, Italy"]},{"name":"University Hospital San Giovanni di Dio e Ruggi d\u2019Aragona","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9749-8092","authenticated-orcid":false,"given":"Angelo","family":"Silverio","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Baronissi, 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