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May 1, 2019

A “New” Parameter for Aortic Stenosis Severity: What Goes Around Comes Around

Author Affiliations
  • 1Mayo Clinic, Rochester, Minnesota
  • 2Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
JAMA Cardiol. 2019;4(6):511-512. doi:10.1001/jamacardio.2019.1344

The timing of intervention for aortic valve stenosis (AS) depends on the accurate determination of AS severity. More patients with a calculated valve area of less than 1.0 cm2 have a mean gradient less than the conventional threshold of 40 mm Hg, resulting in uncertainty regarding the true severity of aortic valve obstruction. Some patients with low-gradient AS may not have truly severe AS, highlighting the flaws inherent to the aortic valve area calculation.1 Several tools exist to further stratify AS severity in such patients, including computed tomography calcium scoring, stress echocardiography, and invasive hemodynamic catheterization with interventions such as exercise, vasodilators, or positive inotropes. However, additional parameters to characterize AS severity are needed.