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Review
. 2023 Jul 29;13(15):2527.
doi: 10.3390/diagnostics13152527.

Echocardiographic Evaluation of Aortic Stenosis: A Comprehensive Review

Rachele Manzo  1 , Federica Ilardi  1 , Dalila Nappa  1 , Andrea Mariani  1 , Domenico Angellotti  1 , Maddalena Immobile Molaro  1 , Giulia Sgherzi  1 , Domenico Simone Castiello  1 , Fiorenzo Simonetti  1 , Ciro Santoro  1 , Mario Enrico Canonico  1 , Marisa Avvedimento  1 , Raffaele Piccolo  1 , Anna Franzone  1 , Giovanni Esposito  1
Affiliations
Review

Echocardiographic Evaluation of Aortic Stenosis: A Comprehensive Review

Rachele Manzo et al. Diagnostics (Basel). .

Abstract

Echocardiography represents the most important diagnostic tool in the evaluation of aortic stenosis. The echocardiographic assessment of its severity should always be performed through a standardized and stepwise approach in order to achieve a comprehensive evaluation. The latest technical innovations in the field of echocardiography have improved diagnostic accuracy, guaranteeing a better and more detailed evaluation of aortic valve anatomy. An early diagnosis is of utmost importance since it shortens treatment delays and improves patient outcomes. Echocardiography plays a key role also in the evaluation of all the structural changes related to aortic stenosis. Detailed evaluation of subtle and subclinical changes in left ventricle function has a prognostic significance: scientific efforts have been addressed to identify the most accurate global longitudinal strain cut-off value able to predict adverse outcomes. Moreover, in recent years the role of artificial intelligence is increasingly emerging as a promising tool able to assist cardiologists in aortic stenosis screening and diagnosis, especially by reducing the rate of aortic stenosis misdiagnosis.

Keywords: aortic stenosis; aortic stenosis grading; artificial intelligence; cardiac damage; echocardiography; multiparametric approach.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comprehensive echocardiographic evaluation of aortic stenosis. CW: continuous wave; LV: left ventricle; PW: pulsed wave; 2D: two-dimensional; 3D: three-dimensional.
Figure 2
Figure 2
Classification system for bicuspid aortic valves adapted by Sievers et al. AP: Anterior-Posterior; BAV: Bicuspid aortic valve; L: Left coronary sinus; LAT: Lateral; N: Non-coronary sinus; R: Right coronary sinus.
Figure 3
Figure 3
Subaortic discrete membrane.
Figure 4
Figure 4
Evaluation of aortic valve morphology. (A) Subcostal view with 2D transthoracic echocardiography might provide a valid alternative in the absence of an adequate parasternal short axis view. (B) Short axis view with 2D transesophageal echocardiography. (C) 3D transesophageal echocardiography for the identification of the smallest aortic valve area.
Figure 5
Figure 5
Stepwise approach to assess aortic stenosis severity. AS = aortic stenosis; AVA = aortic valve area; CT = computed tomography; LVEF = left ventricle ejection fraction; SVi = stroke volume index; Vmax = maximum velocity.
See this image and copyright information in PMC

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