Moderate AS — Does Transvalvular Flow Rate Hold the Key?

Background: Moderate aortic stenosis (AS) is typically regarded as benign and does not require aortic valve replacement (AVR). However, recent literature shows a significant risk of adverse events, at least in some patients. In severe AS, transvalvular flow rate (FR) may be a better predictor of events than indexed stroke volume (SVi). Classically, FR = SV/ejection time (ET), but ET is rarely reported on standard 2D echocardiography. The derivation formula uses parameters typically found in reports: mean gradient (MG), aortic valve area (AVA), and maximum velocity (Vmax) across the valve. This research evaluated the predictive value of FR, calculated by a new “derivation formula” in moderate AS. Objective: To evaluate the association of transaortic FR with outcomes in patients with moderate AS. Design: Retrospective analysis. Participants/Methods: 292 subjects with moderate AS (1.0 to <1.5 cm 2 ) from 2 academic centers were enrolled. Patients with moderate-to-severe mitral stenos more...