Improving Assessment of Aortic Stenosis

"Degenerative" or calcific aortic stenosis is a complex, multifaceted, systemic disease that is not solely limited to the aortic valve but also includes reduced arterial compliance as well as alterations of left ventricular geometry and function. This particular nature of the disease underscores the need for a more comprehensive evaluation of disease severity going beyond the standard parameters routinely used to assess stenosis severity (i.e., peak jet velocity, pressure gradients, valve effective orifice area) or left ventricle function (i.e., left ventricular ejection fraction). The present paper thus proposes to review newer approaches to improve the quantification of disease severity taking into account the interrelation between the different valvular, arterial, and ventricular variables that may be responsible for the appearance of symptoms and/or poorer prognosis in patients with aortic stenosis. (J Am Coll Cardiol 2012;60:169-80) (c) 2012 by the American College of Cardiology Foundation