EACVI/ASE Clinical Recommendations
Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography

https://doi.org/10.1016/j.echo.2017.02.009Get rights and content

Echocardiography is the key tool for the diagnosis and evaluation of aortic stenosis. Because clinical decision-making is based on the echocardiographic assessment of its severity, it is essential that standards are adopted to maintain accuracy and consistency across echocardiographic laboratories. Detailed recommendations for the echocardiographic assessment of valve stenosis were published by the European Association of Echocardiography and the American Society of Echocardiography in 2009. In the meantime, numerous new studies on aortic stenosis have been published with particular new insights into the difficult subgroup of low gradient aortic stenosis making an update of recommendations necessary. The document focuses in particular on the optimization of left ventricular outflow tract assessment, low flow, low gradient aortic stenosis with preserved ejection fraction, a new classification of aortic stenosis by gradient, flow and ejection fraction, and a grading algorithm for an integrated and stepwise approach of aortic stenosis assessment in clinical practice.

Keywords

Aortic stenosis
Echocardiography
Computed tomography
Quantification
Prognostic parameters

Abbreviations

AoA
Aortic cross-sectional area
AR
Aortic regurgitation
AS
Aortic stenosis
AV
Aortic valve
AVA
Aortic valve area
CMR
Cardiac magnetic resonance imaging
CSA
Cross-sectional area
CT
Computed tomography
CW
Continuous-wave
CWD
Continuous-wave Doppler
D
Diameter of the LVOT
EF
Ejection fraction
EOA
Effective orifice area
GLS
Global longitudinal strain
LV
Left ventricle
LVOT
Left ventricular outflow tract
Max
Maximum
MR
Mitral regurgitation
MS
Mitral stenosis
MSCT
Multislice CT
ΔP
Pressure gradient
PR
Pressure recovery
SV
Stroke volume
SVi
Stroke volume index
TTE
Transthoracic echocardiography
TEE
Transesophageal echocardiography
V
Velocity
VTI
Velocity time integral
2D
Two-dimensional
3D
Three-dimensional

Cited by (0)

This article is being co-published in the European Heart Journal – Cardiovascular Imaging and the Journal of the American Society of Echocardiography. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article

Conflict of interest: None declared.

Reprint requests: American Society of Echocardiography, 2100 Gateway Centre Boulevard, Suite 310, Morrisville, NC 27560 (E-mail: [email protected]).

View Abstract