Key result
Stress echocardiography objectively identifies symptomatic, high-risk patients with apparently asymptomatic severe aortic stenosis who require early aortic valve replacement.
Stress echocardiography is crucial for identifying symptomatic, high-risk patients with apparently asymptomatic severe aortic stenosis and for evaluating low-flow, low-gradient aortic stenosis to guide early aortic valve replacement.
Stress echo may aid risk stratification in asymptomatic severe AS; leaves open whether it should guide early AVR timing.
In apparently asymptomatic severe aortic stenosis (AS) group, stress echocardiography objectively identifies symptomatic, high-risk AS patients requiring early aortic valve replacement (AVR). The low-flow, low-gradient AS is well-characterized clinical entity with distinct diagnostic, management, and clinical outcome challenges. A comprehensive two-dimensional transthoracic echocardiography (2D echo) and Doppler and low-dose dobutamine stress echocardiography are of paramount importance for accurate diagnosis and timely decision of AVR. However, clinicians and imaging experts should be aware of the pitfalls and inaccuracies inherent in 2D echo/Doppler measurements and the effects of pathophysiological factors which impact the stroke volume and transvalvular gradient measurements. In appropriate clinical situations, clinicians should take additional help of cardiac computational tomography, cardiac magnetic resonance imaging, and biomarkers.
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Nitin Burkule (2019) conducted a review in Aortic stenosis. Stress echocardiography was evaluated. Stress echocardiography objectively identifies symptomatic, high-risk patients with apparently asymptomatic severe aortic stenosis who require early aortic valve replacement.
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