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Diagnostics
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Diagnosis of Aortic Stenosis
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Diagnosis of Aortic Stenosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 3177

Special Issue Editors

Prof. Dr. Maria Angela Losi

E-Mail Website
Guest Editor
Department of Advanced Medical Sciences, Universita' Federico II, Naples, Italy
Interests: hypertrophic cardiomyopathy; aortic stenosis; echocardiography; heart failure; arterial hypertension
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Anna Franzone

E-Mail Website
Guest Editor
Department of Advanced Medical Sciences, Università Federico II, Naples, Italy
Interests: transcatheter aortic valve implantation; valve heart disease; aortic stenosis

Special Issue Information

Dear Colleagues,

Calcific aortic stenosis (AS) is the most frequent heart valve disease in developed countries. It is characterized by the progressive fibro-calcific remodelling of valve leaflets that evolve into severe stenosis over years. AS is the third most frequent cardiovascular disease after coronary artery disease and systemic arterial hypertension, with a prevalence of 0.4% in the general population and 1.7% in the population >65 years old.

This Special Issue aims to provide a comprehensive representation of diagnostic tools on aortic stenosis by gathering contributions covering all aspects related to this field. The Special Issue will address fundamental questions on finding a definitive diagnosis on AS presence and degree, and will explore the most recent trials and meta-analysis trials on the associated valvular disease in patients with AS.

Prof. Dr. Maria Angela Losi
Prof. Dr. Anna Franzone
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aortic stenosis 
  • echocardiography 
  • cardiac computer tomography 
  • cardiac nuclear magnetic resonance

Published Papers (2 papers)

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Review

19 pages, 2084 KiB  
Review
Imaging of Bioprosthetic Valve Dysfunction after Transcatheter Aortic Valve Implantation
by Louhai Alwan, Benedikt Bernhard, Nicolas Brugger, Stefano F. de Marchi, Fabien Praz, Stephan Windecker, Thomas Pilgrim and Christoph Gräni
Diagnostics 2023, 13(11), 1908; https://doi.org/10.3390/diagnostics13111908 - 29 May 2023
Cited by 1 | Viewed by 1314
Abstract
Transcatheter aortic valve implantation (TAVI) has become the standard of care in elderly high-risk patients with symptomatic severe aortic stenosis. Recently, TAVI has been increasingly performed in younger-, intermediate- and lower-risk populations, which underlines the need to investigate the long-term durability of bioprosthetic [...] Read more.
Transcatheter aortic valve implantation (TAVI) has become the standard of care in elderly high-risk patients with symptomatic severe aortic stenosis. Recently, TAVI has been increasingly performed in younger-, intermediate- and lower-risk populations, which underlines the need to investigate the long-term durability of bioprosthetic aortic valves. However, diagnosing bioprosthetic valve dysfunction after TAVI is challenging and only limited evidence-based criteria exist to guide therapy. Bioprosthetic valve dysfunction encompasses structural valve deterioration (SVD) resulting from degenerative changes in the valve structure and function, non-SVD resulting from intrinsic paravalvular regurgitation or patient–prosthesis mismatch, valve thrombosis, and infective endocarditis. Overlapping phenotypes, confluent pathologies, and their shared end-stage bioprosthetic valve failure complicate the differentiation of these entities. In this review, we focus on the contemporary and future roles, advantages, and limitations of imaging modalities such as echocardiography, cardiac computed tomography angiography, cardiac magnetic resonance imaging, and positron emission tomography to monitor the integrity of transcatheter heart valves. Full article
(This article belongs to the Special Issue Diagnosis of Aortic Stenosis)
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14 pages, 1584 KiB  
Review
ABCDEG Stress Echocardiography in Aortic Stenosis
by Quirino Ciampi, Lauro Cortigiani, Maria Rivadeneira Ruiz, Andrea Barbieri, Fiore Manganelli, Fabio Mori, Maria Grazia D’Alfonso, Francesca Bursi and Bruno Villari
Diagnostics 2023, 13(10), 1727; https://doi.org/10.3390/diagnostics13101727 - 12 May 2023
Viewed by 1453
Abstract
Rest and stress echocardiography (SE) plays a pivotal role in the evaluation of valvular heart disease. The use of SE is recommended in valvular heart disease when there is a mismatch between resting transthoracic echocardiography findings and symptoms. In aortic stenosis (AS), rest [...] Read more.
Rest and stress echocardiography (SE) plays a pivotal role in the evaluation of valvular heart disease. The use of SE is recommended in valvular heart disease when there is a mismatch between resting transthoracic echocardiography findings and symptoms. In aortic stenosis (AS), rest echocardiographic analysis is a stepwise approach that begins with the evaluation of aortic valve morphology and proceeds to the measurement of the transvalvular aortic gradient and aortic valve area (AVA) using continuity equations or planimetry. The presence of the following three criteria suggests severe AS: AVA < 1.0 cm2, a peak velocity > 4.0 m/s, or a mean gradient > 40 mmHg. However, in approximately one in three cases, we can observe a discordant AVA < 1 cm2 with a peak velocity < 4.0 m/s or a mean gradient <40 mmHg. This is due to reduced transvalvular flow associated with LV systolic dysfunction (LVEF < 50%) defined as “classical” low-flow low-gradient (LFLG) AS or normal LVEF “paradoxical” LFLG AS. SE has an established role in evaluating LV contractile reserve (CR) patients with reduced LVEF. In classical LFLG AS, LV CR distinguished pseudo-severe AS from truly severe AS. Some observational data suggest that long-term prognosis in asymptomatic severe AS may not be as favorable as previously thought, offering a window of opportunity for intervention prior to the onset of symptoms. Therefore, guidelines recommend evaluating asymptomatic AS with exercise stress in physically active patients, particularly those younger than 70 years, and symptomatic classical LFLG severe AS with low-dose dobutamine SE. A comprehensive SE assessment includes evaluating valve function (gradients), the global systolic function of the LV, and pulmonary congestion. This assessment integrates considerations of blood pressure response, chronotropic reserve, and symptoms. StressEcho 2030 is a prospective, large-scale study that employs a comprehensive protocol (ABCDEG) to analyze the clinical and echocardiographic phenotypes of AS, capturing various vulnerability sources which support stress echo-driven treatment strategies. Full article
(This article belongs to the Special Issue Diagnosis of Aortic Stenosis)
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