Valvular & structural heart diseaseResearch article
Novel Transvalvular Flow Criteria Reduce Indeterminate Stress Echocardiography and Refine Risk Stratification in Low-Gradient Aortic Stenosis
- retrospectively analyzed
- real-world study
Authors' conclusion
In this real-world study, the transvalvular flow-based criteria for severe AS markedly reduced the number of indeterminate DSE. Within the indeterminate AS group, patients with reclassified severe AS derived benefit from aortic valve intervention.
Study context
- Population
- Patients with classical low-gradient aortic stenosis (AVA <1 cm 2 with aortic valve mean gradient <40 mm Hg) with reduced left ventricular ejection fraction who underwent dobutamine stress echocardiography (DSE)patients with classical low-gradient aortic stenosis who underwent DSE
- Participants
- 287 patients
- Comparison
- Conventional vs proposed combined transvalvular flow criteria for AS classification after DSE
- severe ASn = 84
- moderate ASn = 81
- indeterminate ASn = 122
Main finding
As reported in the abstract
Aortic valve intervention · median follow-up of 12.0 (interquartile range, 5-33) months
Further findings
Benefit of aortic valve intervention
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| aortic valve intervention · reclassified severe AS | 0.50 (0.27–0.92) | P = 0.03 | |
| aortic valve intervention · remaining indeterminate AS group | 0.77 (0.22–2.75) | P = 0.69 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Outcome after aortic valve intervention · conventionally diagnosed severe AS had a better outcome | 2.88 (1.34–6.21) | P = 0.007 | |
| 0.10.31310Hazard ratio (log scale) |
Diagnostic tests with the newly proposed criteria
- Proportion of diagnostic tests in the overall population
- from 57% to 91%
- Proportion of indeterminate AS
- 9%
Original publication
Novel Transvalvular Flow Criteria Reduce Indeterminate Stress Echocardiography and Refine Risk Stratification in Low-Gradient Aortic Stenosis. Circ Cardiovasc Imaging. Published 23 September 2026. doi:10.1161/circimaging.125.018621
Summarised from the published abstract; every number is checked against it