Polish Multicenter Registry (Pol-Las-Se Registry). Stress Echocardiography In Low-Gradient Aortic Stenosis In Poland: Numbers, Settings, Results, Complications, And Clinical Practice

Background: The diagnostic workup of low-gradient aortic stenosis (LG AS) is a challenge in clinical practice.Aims: Therefore, our goal was to assess the diagnostic value of stress echocardiography (SE) performed in patients with undefined LG AS with low and preserved ejection fraction (EF) and the impact of its result on therapeutic decisions in Polish third-degree care facilities.Methods: All the patients with LG AS and with SE performed were recruited in 16 Polish departments of cardiology between 2017 and 2019. The main exclusion criteria were as follows: moderate or severe aortic or mitral regurgitation, mitral stenosis.Results: The study group included 163 patients (52 % males) with LG AS who underwent SE for adequate diagnostic and therapeutic decision. In 14 patients DSE were non-diagnostic. The mean aortic valve (AV) pressure gradient was 24.1 (7.3) mmHg, while an AV area was 0.86 (0.2) cm(2). Among 149 patients with conclusive DSE, severe AS was found in 59.8%, pseudo-severe in 22% and moderate AS in 18%. There were no cases of death or vascular events related to DSE. Among 142 patients sixty-three (44%) patients had an aortic valve intervention in a follow-up (median - 208 days; lower - upper quartile, 73 - 531 days). Based on the result of DSE test, severe AS was significantly more often associated with qualification to intervention compared to the moderate and pseudo-severe subgroups (P < 0.0001).Conclusions: DSE test in severe AS is a valuable diagnostic tool in patients with LG AS in Poland.