Aortic Valve Calcification Helps Distinguish Severity in Discordant Aortic Stenosis

When the valve area says severe but the gradient says moderate, a CT scan might be informative.

Severe aortic stenosis (AS) is typically characterized by small valve area and high gradient (≥40 mm Hg or peak aortic jet velocity of ≥4 m/sec). However, some patients with severe AS based on valve area have low (discordant) gradients, despite normal left ventricular ejection fraction (LVEF) and flow, confounding diagnosis and treatment. In this multicenter study, investigators reviewed echocardiographic and computed tomographic (CT) scans of 646 patients with moderate or severe AS and normal LVEF and identified 172 patients with severe AS by valve area but discordantly low gradients.

Compared with patients with concordant valve-area and gradient findings, patients with discordant findings were less likely to be women and had a lower mean g…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)