Severity of Aortic Stenosis in Adults
Current ACC/AHA guidelines recommend cut-off values for Doppler-echocardiographic measurements of severe aortic stenosis (AS) as follows:
aortic valve area (AVA) <1.0 cm2 and/or indexed for body surface area <0.6 cm2/m2, mean gradient >40 mmHg and peak velocity >4.0 m/s (1).
Similarly, ESC guidelines set the mean transvalvular gradient of >50 mmHg (2) (Table 1). However, inconsistent grading of AS remains a common problem in clinical practice, both in patients with impaired and normal LV functions. A common pattern is the combination of an AVA <1 cm2 with a gradient <40 mmHg.
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