Invasive assessment of aortic stenosis in contemporary practice

Brito, João; Raposo, Luís; Teles, Rui Campante

doi:10.3389/fcvm.2022.1007139

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…Such an integrated, multimodality approach should be considered fundamental in guiding treatment decisions and providing optimal patient counseling. 45…”

Section: The Role Of Multimodality Cardiovascular Imagingmentioning

confidence: 99%

“…It is critical to understand the hemodynamic concepts behind AS evaluation to identify potential inconsistencies in diagnosis and the subsets of patients that benefit from an integrated approach that includes cardiac catheterization. Such an integrated, multimodality approach should be considered fundamental in guiding treatment decisions and providing optimal patient counseling 45 …”

Section: The Role Of Multimodality Cardiovascular Imagingmentioning

confidence: 99%

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Moderate aortic stenosis: Navigating the uncharted

Caprio,

De Donno,

Bisaccia

et al. 2024

Echocardiography

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Aortic stenosis (AS) stands as the most common valvular heart disease in developed countries and is characterized by progressive narrowing of the aortic valve orifice resulting in elevated transvalvular flow resistance, left ventricular hypertrophy, and progressive increased risk of heart failure and sudden death. This narrative review explores clinical challenges and evolving perspectives in moderate AS, where discrepancies between aortic valve area and pressure gradient measurements may pose diagnostic and therapeutic quandaries. Transthoracic echocardiography is the first‐line imaging modality for AS evaluation, yet cases of discordance may require the application of ancillary noninvasive diagnostic modalities. This review underscores the importance of accurate grading of AS severity, especially in low‐gradient phenotypes, emphasizing the need for vigilant follow‐up. Current clinical guidelines primarily recommend aortic valve replacement for severe AS, potentially overlooking latent risks in moderate disease stages. The noninvasive multimodality imaging approach—including echocardiography, cardiac magnetic resonance, computed tomography, and nuclear techniques—provides unique insights into adaptive and maladaptive cardiac remodeling in AS and offers a promising avenue to deliver precise indications and exact timing for intervention in moderate AS phenotypes and asymptomatic patients, potentially improving long‐term outcomes. Nevertheless, what we may have gleaned from a large amount of observational data is still insufficient to build a robust framework for clinical decision‐making in moderate AS. Future research will prioritize randomized clinical trials designed to weigh the benefits and risks of preemptive aortic valve replacement in the management of moderate AS, as directed by specific imaging and nonimaging biomarkers.

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“…Such an integrated, multimodality approach should be considered fundamental in guiding treatment decisions and providing optimal patient counseling. 45…”

Section: The Role Of Multimodality Cardiovascular Imagingmentioning

confidence: 99%

Section: The Role Of Multimodality Cardiovascular Imagingmentioning

confidence: 99%