Baumgartner Helmut, Hung Judy, Bermejo Javier, Chambers John B, Edvardsen Thor, Goldstein Steven, Lancellotti Patrizio, LeFevre Melissa, Miller Fletcher, Otto Catherine M
Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
J Am Soc Echocardiogr. 2017 Apr;30(4):372-392. doi: 10.1016/j.echo.2017.02.009.
Echocardiography is the key tool for the diagnosis and evaluation of aortic stenosis. Because clinical decision-making is based on the echocardiographic assessment of its severity, it is essential that standards are adopted to maintain accuracy and consistency across echocardiographic laboratories. Detailed recommendations for the echocardiographic assessment of valve stenosis were published by the European Association of Echocardiography and the American Society of Echocardiography in 2009. In the meantime, numerous new studies on aortic stenosis have been published with particular new insights into the difficult subgroup of low gradient aortic stenosis making an update of recommendations necessary. The document focuses in particular on the optimization of left ventricular outflow tract assessment, low flow, low gradient aortic stenosis with preserved ejection fraction, a new classification of aortic stenosis by gradient, flow and ejection fraction, and a grading algorithm for an integrated and stepwise approach of aortic stenosis assessment in clinical practice.
超声心动图是诊断和评估主动脉瓣狭窄的关键工具。由于临床决策基于对其严重程度的超声心动图评估，因此采用标准以确保各超声心动图实验室的准确性和一致性至关重要。欧洲超声心动图协会和美国超声心动图协会于2009年发布了关于瓣膜狭窄超声心动图评估的详细建议。与此同时，关于主动脉瓣狭窄的众多新研究已经发表，特别是对低跨瓣压差主动脉瓣狭窄这一复杂亚组有了新的见解，因此有必要更新建议。本文件特别关注左心室流出道评估的优化、射血分数保留的低流量、低跨瓣压差主动脉瓣狭窄、根据跨瓣压差、流量和射血分数对主动脉瓣狭窄进行的新分类，以及临床实践中主动脉瓣狭窄评估的综合和逐步方法的分级算法。
