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Editorial
. 2021 Nov 16;10(22):e023531.
doi: 10.1161/JAHA.121.023531. Epub 2021 Oct 30.

Aortic Stenosis: The Old Disease With New (and Evolving) Faces

Calvin Woon-Loong Chin  1
Affiliations
Editorial

Aortic Stenosis: The Old Disease With New (and Evolving) Faces

Calvin Woon-Loong Chin. J Am Heart Assoc. .
No abstract available

Keywords: aortic stenosis; classical low‐flow low‐gradient severe aortic stenosis; low‐flow low‐gradient severe aortic stenosis; normal‐flow low‐gradient severe aortic stenosis; risk stratification.

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Figures

Figure 1
Figure 1. Management of severe aortic stenosis stratified by gradient states.
The recommendations for aortic valve replacement (AVR) in high‐gradient severe aortic stenosis (AS) are guided by symptoms and/or reduced left ventricular ejection fraction (LVEF). In the absence of symptoms and preserved LVEF, AVR may be considered in patients with high‐gradient severe AS when there is evidence of other abnormal findings. In low‐gradient states, aortic valvular area remains an important parameter to establish severity. AVR is currently recommended in 2 groups of symptomatic patients with low‐gradient severe AS: true severe in those with reduced LVEF and those with paradoxical low‐flow low‐gradient severe AS. AVA indicates aortic valvular area; EU, European Union; HTN, hypertension; LOE, level of evidence; MPG, mean pressure gradient; NFLG, normal‐flow low‐gradient; PLFLG, paradoxical low‐flow low‐gradient; SVi, indexed stroke volume; and Vm, peak aortic jet velocity.
Figure 2
Figure 2. Disease severity, symptoms, and presentation of aortic stenosis.
The complex interaction between the valve and underlying comorbidities on the myocardium ultimately affects the aortic stenosis (AS) severity, symptoms and presentation of the patients. Because of this complexity, conventional echocardiographic assessment of AS severity may not be sufficient to make an accurate diagnosis in some patients; and further investigations are needed to ascertain severity and symptoms of patients. LVEF indicates left ventricular ejection fraction.
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References

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