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The guideline-recommended use of Doppler echocardiography alone for assessing aortic stenosis severity should be critically revisited due to poor correlation with invasive hemodynamics in real-world practice.
Recent real world comparisons of echo and invasive assessment of transaortic pressure gradients in aortic stenosis often show a poor correlation. The guideline recommended use of Doppler echo without hemodynamic assessments may not reflect the variability of echo measurements in practice, particularly in unselected patients. An approach using both echo and invasive data is often used in practice today. The guideline recommended use of echo assessments alone should be critically revisited.
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Feldman et al. (2016) studied this question.
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