Table 1 Clinical and imaging characteristics of high-gradient severe, classic LF-LG, paradoxical LF-LG AS groups (n = 511).

No. of patients (%)

438 (85.7)

18 (3.5)

55 (10.8)

Age, years

66.8 ± 8.8

66.8 ± 6.2

67.3 ± 9.4

0.93

Male

236 (53.9)

13 (72.2)

31 (56.4)

0.30

BSA, m²

1.6 ± 0.2

1.7 ± 0.2

1.6 ± 0.2

0.56

Hypertension

231 (52.7)

12 (66.7)

30 (54.5)

0.50

Atrial fibrillation

65 (14.8)

4 (22.2)

4 (7.3)

0.20

PCI or CABG

94 (21.5)

9 (50.0)*

14 (25.5)

0.02

BNP, pg/mL

99.5 (43.0–280.5)

944.5 (304.8–3066.0)*

70.0 (35.0–190.0)

< 0.001

lnBNP

4.6 (3.8–5.6)

6.8 (5.7–8.0)*

4.2 (3.6–5.2)

< 0.001

Echocardiography

LVEF, %

60.3 ± 10.0

36.0 ± 10.3*

62.6 ± 5.3

< 0.001

Peak velocity, m/s

5.2 ± 0.7

3.6 ± 0.5*

3.5 ± 0.5^†

< 0.001

Peak PG, mmHg

108.5 ± 30.5

52.0 ± 13.1*

50.1 ± 16.0^†

< 0.001

Mean PG, mmHg

66.5 ± 19.4

29.8 ± 7.9*

28.0 ± 9.5^†

< 0.001

LVMI, g/m²

135.4 ± 35.8

149.6 ± 31.1

124.9 ± 36.2

0.03

AV VTI, cm

124.6 ± 26.1

94.9 ± 33.3*

112.0 ± 27.7^†

< 0.001

LVOT VTI, cm

21.4 ± 4.1

16.0 ± 4.4*

21.2 ± 3.7

< 0.001

LVOT diameter, mm

21.0 ± 1.5

21.8 ± 1.9

21.2 ± 1.6

0.06

LVOT diameter/BSA

12.9 ± 1.3

13.1 ± 1.6

13.0 ± 1.3

0.55

AVA_echo, mm²

61.3 ± 14.7

66.9 ± 15.1

69.5 ± 13.8^†

< 0.001

ESVI, mL/m²

27.7 ± 16.8

63.4 ± 27.0*

24.5 ± 11.4

< 0.001

EDVI, mL/m²

66.8 ± 23.7

96.3 ± 29.3*

64.3 ± 24.5

< 0.001

SAC, mL/m²/mmHg

0.8 ± 0.3

0.7 ± 0.3

0.8 ± 0.3

0.28

Zva, mmHg/mL/m²

5.3 ± 1.6

5.0 ± 1.9

4.4 ± 1.4^†

< 0.001

CT findings

Valve morphology

0.04

 Tricuspid

204 (46.6)

14 (77.8)

28 (50.9)

 Bicuspid with raphe

106 (24.2)

3 (16.7)

17 (30.9)

 Bicuspid without raphe

128 (29.2)

1 (5.6)

10 (18.2)

AVC, Agatston unit

3027.2 ± 1872.0

2895.5 ± 1624.5

2363.1 ± 1605.8^†

0.04

AVC_ratio^‡

1.8 ± 1.0

1.6 ± 0.8

1.4 ± 0.8^†

0.006

LVOT mean diameter

24.8 ± 2.9

27.1 ± 2.7*

24.7 ± 2.6

0.003

AVA_CT, mm²

84.9 ± 23.4

100.8 ± 22.7*

94.2 ± 25.0^†

0.001

AVA_plani, mm²

87.2 ± 23.2

99.7 ± 25.5*

97.5 ± 27.1^†

0.003

Aortic annulus

 Circularity, %

81.6 ± 7.6

77.4 ± 6.6

82.3 ± 6.0

0.05

 Maximal dimeter, mm

27.5 ± 3.2

30.4 ± 3.5*

27.4 ± 2.8

0.001

 Mean diameter, mm

24.9 ± 2.6

26.9 ± 2.5*

25.0 ± 2.6

0.005

 Perimeter, mm

79.5 ± 8.4

85.4 ± 7.7*

80.0 ± 8.3

0.02

 Area, mm²

481.8 ± 102.4

554.8 ± 101.0*

489.5 ± 99.9

0.01

Sinus of Valsalva, mm

36.6 ± 4.5

38.4 ± 4.7

36.8 ± 5.0

0.25

Sinotubular junction, mm

30.9 ± 4.6

31.7 ± 3.3

31.5 ± 5.9

0.58

Ascending aorta tubular portion, mm

40.7 ± 6.3

38.4 ± 4.6

40.4 ± 7.7

0.31

Normalized to BSA

AVA_CT, mm²

51.7 ± 13.6

60.7 ± 15.8*

58.0 ± 15.6^†

< 0.001

AVA_plani, mm²

52.6 ± 13.5

59.5 ± 17.5*

57.8 ± 15.2^†

0.005

Aortic annulus

 Maximal dimeter, mm

16.8 ± 2.0

18.2 ± 2.6*

16.9 ± 1.7

0.01

 Mean diameter, mm

15.2 ± 1.6

16.1 ± 1.9

15.4 ± 1.6

0.06

 Perimeter, mm

48.7 ± 5.2

51.1 ± 5.8

49.2 ± 5.3

0.12

 Area, mm²

293.4 ± 55.5

331.0 ± 56.6*

299.7 ± 55.9

0.02

Sinus of Valsalva, mm

22.4 ± 2.9

23.0 ± 2.8

22.6 ± 2.9

0.65

Sinotubular junction diameter, mm

18.9 ± 2.9

18.9 ± 2.1

19.3 ± 3.2

0.69

Ascending aorta tubular portion, mm

25.0 ± 4.3

23.0 ± 2.9

24.8 ± 4.6

0.15

Surgical valve size, mm

22.1 ± 2.1

23.0 ± 2.1

22.3 ± 2.0

0.18

Surgical valve type

N/A

CE Magna

144

10

18

ATSAP

82

4

8

Hancock

82

1

13

St. Jude Regent

80

3

11

Others

50

0

5

Operator

0.47

Operator 1

170

5

18

Operator 2

95

2

12

Operator 3

81

4

15

Operator 4

64

4

7

Operator 5

28

3

3

MACCE

34 (7.8)

5 (27.8)*

4 (7.3)

0.01

All-cause mortality

57 (13.0)

6 (33.3)

8 (14.5)

0.05

Follow-up duration, d

1517.5 (1188.8–2026.5)

1134.0 (26.0–1682.0)

1455.0 (1112.0–1944.0)

0.007