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. 2022 May 7;12:7506. doi: 10.1038/s41598-022-11491-3

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© The Author(s) 2022

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Box plot to demonstrate the distribution of AVC_ratio, LVOT mean diameter, and maximal diameter of aortic annulus according to subtypes. (a) AVC_ratio was calculated by dividing AVC with sex-specific thresholds (Male, 2000; Female, 1250). The score above the red-dotted line represents AVC above the sex-specific threshold, and consequently, severe aortic stenosis. The score below the red-dotted line represents the AVC below the sex-specific threshold and nonsevere calcification. The mean of AVC_ratio was significantly lower in paradoxical LF-LG AS than that of high gradient severe AS (P = 0.001). In addition, the proportion of nonsevere calcification was most frequent in paradoxical LF-LG AS patients. Both (b) LVOT mean diameter and (c) maximal diameter of aortic annulus were lowest in LF-LG AS patients among the three subtypes and significantly larger than those of high-gradient severe AS patients. AS aortic stenosis, AVC aortic valve calcium score, LF-LG low-flow and low-gradient, LVOT left ventricular outflow tract.