Expert Consensus Document on the Assessment of the Severity of Aortic Valve Stenosis by Echocardiography to Provide Diagnostic Conclusiveness by Standardized Verifiable Documentation

Overview

Journal Clin Res Cardiol

Specialty Cardiology & Vascular Diseases

Date 2019 Sep 5

PMID 31482241

Citations 12

Authors

Andreas Hagendorff

Fabian Knebel

Andreas Helfen

Jan Knierim

Christoph Sinning

Stephan Stobe

Wolfgang Fehske

Sebastian Ewen

Affiliations

Soon will be listed here.

Abstract

According to recent recommendations on echocardiographic assessment of aortic valve stenosis direct measurement of transvalvular peak jet velocity, calculation of transvalvular mean gradient from the velocities using the Bernoulli equation and calculation of the effective aortic valve area by continuity equation are the appropriate primary key instruments for grading severity of aortic valve stenosis. It is obvious that no gold standard can be declared for grading the severity of aortic stenosis. Thus, conclusions of the exclusive evaluation of aortic stenosis by Doppler echocardiography seem to be questionable due to the susceptibility to errors caused by methodological limitations, mathematical simplifications and inappropriate documentation. The present paper will address practical issues of echocardiographic documentation to satisfy the needs to analyze different scenarios of aortic stenosis due to various flow conditions and pressure gradients. Transesophageal and multidimensional echocardiography should be implemented for reliable measurement of geometric aortic valve area and of cardiac dimensions at an early stage of the diagnostic procedure to avoid misinterpretation due to inconsistent results.

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