In our study, all patients were regularly followed in our outpatient heart valve clinic. Both soft and hard events were considered in a composite end point defined as cardiovascular death or need for AVR motivated by the development of symptoms or LV dysfunction. This eliminates bias related to the inclusion of AVR not dictated by symptoms. As mentioned by Dr. Parras, there are some discrepancies in the hazard ratios reported in the “Results” section of the report and in Table 4 [(1)]. Nevertheless, these differences did not affect the interpretation of the results. In fact, such differences are explained by different multivariate models used in the 2 sections. According to the statistical review, it was suggested, to avoid overfitting of the models, not to include variables with high degrees of colinearity. These changes were reported in Table 4 [(1)], but not in the text, in which the multivariate model including all variables was provided. Peak aortic velocity and mean aortic gradient are closely and directly correlated. Therefore, it may be difficult to admit that those variables predict events in a contradictory fashion. However, this reflects the statistical models used. The normal-flow low-gradient entity represented the referent group. This is the reason why the peak aortic velocity or the low-flow pattern predicted the outcome compared with the referent group. However, outcome prediction was more significant in the low-flow low-gradient entity. These results were obtained even if the incidence of the low-flow low-gradient AS pattern was low. Of note, 82% of patients in this category experienced cardiac events during follow-up. Furthermore, chance has no role to play in these results.