Paradoxical low-gradient aortic stenosis : characterization and natural history of a complex and heterogeneous entity

Calcific aortic stenosis is the most prevalent heart valve disorder in developed countries with aortic valve replacement remaining the only effective treatment. Diagnosis and staging of aortic stenosis severity are crucial and rely on echocardiographic parameters. However, in recent years, a subgroup of patients has been identified as exhibiting discordant grading criteria, raising uncertainty about true severity and subsequently about prognosis and appropriate management. Currently, there is considerable debate as to the clinical significance of these “paradoxical low-gradient” severe aortic stenosis. Some authors consider this pattern as a more advanced stage of the aortic stenosis disease, whereas others suggest it could be a less malignant form. The present thesis work takes place in the context of this controversy and intends to bring new insights in this complex and heterogeneous entity.(MED - Sciences médicales) -- UCL, 201