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Publication :
How do we reconcile echocardiography, computed tomography, and hybrid imaging in assessing discordant grading of aortic stenosis severity?

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Date

2019-02-04

Auteurs

Delgado, Victoria
Hahn, Rebecca T.
Gillam, Linda
Bax, Jeroen
Sengupta, Partho P.

Direction de publication

Direction de recherche

Titre de la revue

ISSN de la revue

Titre du volume

Éditeur

Elsevier

Projets de recherche

Structures organisationnelles

Numéro de revue

Résumé

Up to 40% of patients with aortic stenosis (AS) present with a “discordant grading” usually referred to as “low-gradient AS.” This article presents a step-by-step integrative approach overview of the utility, limitations, and complementary role of the different imaging modalities for the assessment of AS severity with a special emphasis on the reconciliation of discordant grading. The first step is to confirm the validity of echocardiographic measures of AS severity. For example, hybrid imaging can combine left ventricular outflow tract area measured by 3-dimensional echocardiography or contrast enhanced multidetector row computed tomography with flow velocities measured by Doppler. The next step is to differentiate severe from non-severe AS with the use of low-dose dobutamine stress echocardiography, especially in patients with low left ventricular ejection fraction, low-flow, low-gradient AS. Aortic valve calcium scoring measured by noncontrast multidetector row computed tomography is preferred in patients with low-gradient AS and preserved left ventricular ejection fraction as well as in those with inconclusive results with dobutamine stress echocardiography.

Description

Revue

JACC. Cardiovascular imaging, Vol. 12 (2), 267–282 (2019)

DOI

10.1016/j.jcmg.2018.11.027

URL vers la version publiée

Mots-clés

Aortic stenosis, Aortic valve replacement, Computed tomography, Doppler echocardiography, Hybrid imaging

Citation

Licence CC

Type de document