Echocardiographic features in diagnosing aortic stenosis

Abstract

Introduction. Aortic stenosis (AS) is a valvular condition that obstructs left ventricular outflow, commonly seen in the elderly and associated with increased morbidity and mortality. Echocardiography remains the standard for early diagnosis, severity assessment, monitoring, and guiding therapeutic management. Aim of the study. Review of the literature on essential echocardiographic features for the diagnosis and staging of aortic stenosis, as well as the predictive value of parameters in therapeutic decision-making. Materials and methods. A narrative synthesis of relevant scientific articles from the past five years was performed, using databases such as PubMed, HINARI, Scopus, and SAGE. The following main echocardiographic parameters essential for diagnosis were evaluated: aortic valve area (AVA), peak transvalvular jet velocity (Vmax), and mean pressure gradient. Results. Research noted that mild stenosis is defined by an AVA >1.5 cm² and Vmax <3 m/s, moderate stenosis is characterized by an AVA between 1.0–1.5 cm² and Vmax 3–4 m/s, severe stenosis by an AVA <1.0 cm², Vmax ≥4 m/s, and a mean gradient ≥40 mmHg. In special forms such as low-flow, low-gradient AS, the AVA is <1.0 cm² but with a gradient <40 mmHg, observed in patients with reduced ejection fraction. In these cases, complementary methods like dobutamine stress echocardiography, a functional test for contractility assessment or CT calcium scoring, are necessary to differentiate severe from moderate forms and to guide clinical decisions. Conclusion(s). Echocardiography enables the early diagnosis of aortic stenosis through the evaluation of AVA, Vmax, and mean gradient, thus facilitating the identification of severe or atypical forms, guiding therapeutic approaches, and supporting decisions regarding the optimal timing of interventional treatment.