Current and new imaging techniques in risk stratification of asymptomatic severe aortic stenosis

Abstract

Aortic stenosis (AS) is one of the most common valvular diseases in clinical practice. The prevalence of calcified AS with moderate or severe stenosis exceeds 2% after 75 years. The optimal timing of intervention for asymptomatic severe AS is uncertain and controversial. Identification of high-risk patients is based on echocardiographic parameters (left ventricular dysfunction, AS severity and progression), hemodynamic response to exercise, pulmonary hypertension, and elevated brain natriuretic peptides. However, early surgical aortic valve replacement (AVR), when compared to the watchful waiting approach, was associated with survival advantage. Moreover, new insights into pathophysiology of AS and advances in imaging modalities were helpful in the management of asymptomatic AS. In this report, we detail the potential role of echocardiography to guide timing of surgery and we discussed the use of early risk features based on recent imaging modalities.

Keywords:

• Aortic stenosis
• echocardiography
• cardiac magnetic resonance
• surgery

Author contributions

All authors have contributed equally to the work. All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by [Ahmed Sghaier], [Emna Bennour], [Ikram Kammoun], and [Lobna LAroussi]. The first draft of the manuscript was written by [Ahmed Sghaier] and [ikram kammoun] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors declare that they have no competing interests.

Data availability statement

Data sharing are available upon asking from the corresponding author.