Low-flow severe aortic stenosis with preserved ejection fraction, N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiovascular remodeling.

) criteria (3,4).Patients with this form of severe AS are often under-recognized, and the therapeutic options applied arenot optimal (5,6). The recognition of mechanisms lead-ing to low flow and low stroke volume (SV) mayimprove the diagnosis, treatment and prognosisamong this patient population. In patients with AS andLVEF >50%, a reduced SV appears to be related to thefollowing processes: (i) a disturbed LV geometry andfunction; and (ii) a higher LV afterload, composed ofan altered aortic valve resistance and resistance fromthe modified vascular system structure and function.