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Acceleration Time in Aortic Stenosis

Acceleration Time in Aortic Stenosis Circulation: Cardiovascular Imaging EDITORIAL A New Life for an Old Parameter See Article by Einarsen et al Sylvestre Maréchaux , MD, PhD Christophe Tribouilloy , ccording to current guidelines, aortic stenosis (AS) in patients with pre- MD, PhD served left ventricular (LV) ejection fraction is defined as a mean pressure Agradient ≥40 mm Hg, corresponding to an aortic valve peak velocity ≥4 2 1 m/s or an aortic valve area (AVA) ≤1.0 cm . However, up to 40% of patients may present an AVA in the severe range but without correspondingly high gradients and velocities. In such cases of discordant results, once a measurements error has been ruled out, patients who have indeed moderate AS should be differenti- ated from those with truly severe AS who may benefit from aortic valve replace- ment. Thus, additional parameters are necessary to refine the diagnostic workup of such AS patients. Severe AS is associated with a delay (tardus) and reduction (parvus) in the upstroke of the aortic pressure, beginning at aortic valve opening, thus resulting in a delay to achieve the maximal instantaneous transvalvular gradient, leading to an increase in acceleration time (AT) by continuous wave Doppler (Figure  1). In addition, although http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Circulation: Cardiovascular Imaging Wolters Kluwer Health

Acceleration Time in Aortic Stenosis

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Publisher
Wolters Kluwer Health
Copyright
© 2021 American Heart Association, Inc.
ISSN
1941-9651
eISSN
1942-0080
DOI
10.1161/circimaging.120.012234
Publisher site
See Article on Publisher Site

Abstract

Circulation: Cardiovascular Imaging EDITORIAL A New Life for an Old Parameter See Article by Einarsen et al Sylvestre Maréchaux , MD, PhD Christophe Tribouilloy , ccording to current guidelines, aortic stenosis (AS) in patients with pre- MD, PhD served left ventricular (LV) ejection fraction is defined as a mean pressure Agradient ≥40 mm Hg, corresponding to an aortic valve peak velocity ≥4 2 1 m/s or an aortic valve area (AVA) ≤1.0 cm . However, up to 40% of patients may present an AVA in the severe range but without correspondingly high gradients and velocities. In such cases of discordant results, once a measurements error has been ruled out, patients who have indeed moderate AS should be differenti- ated from those with truly severe AS who may benefit from aortic valve replace- ment. Thus, additional parameters are necessary to refine the diagnostic workup of such AS patients. Severe AS is associated with a delay (tardus) and reduction (parvus) in the upstroke of the aortic pressure, beginning at aortic valve opening, thus resulting in a delay to achieve the maximal instantaneous transvalvular gradient, leading to an increase in acceleration time (AT) by continuous wave Doppler (Figure  1). In addition, although

Journal

Circulation: Cardiovascular Imaging – Wolters Kluwer Health

Published: Jan 19, 2021

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