Modern approaches to aortic stenosis diagnostics

Modern approaches to aortic stenosis diagnostics
Sinkov A.V.

Irkutsk State Medical University

In 2017 there were published two fundamental international guidelines for doctors devoted to a problem of aortic stenosis (AS) diagnostics, prepared by leading experts in the field: joint guidelines of the European Society of Cardiology (ESC) and the European Association For Cardio-Thoracic Surgery (EACTS) for diagnostics and treatment of heart valve disease (2017 ESC / EACTS Guidelines for the management of valvular heart disease), and the second edition of the textbook of the European Association of Cardiovascular Imaging (the EACVI Textbook of Echocardiography, 2 ed.). Algorithms for diagnostics of the AS in these guidelines are designed to optimize adoption of diagnostic solutions in everyday medical practice, from a district polyclinic to cardiosurgical center. The review presents current data on epidemiology, etiology and diagnostics of the AS, stage classification of aortic valve (AV) calcification, quantifying severity of the AS, causes of systematic and random errors of measurements in evaluation of the severity of AS, differential diagnosis of the AS with a low flow — low gradient with a reduced ejection fraction (EF), severe AS with a paradoxically low blood flow — low gradient with a preserved EF, indications for interventional treatment of the AS, requirements for a standard echocardiographic report in the evaluation of patients with the AS. Acquaintance of practicing physicians with modern approaches to the diagnostics of AS contained in these guidelines will help to improve clinical outcomes of the AS.

Key words: aortic valve, aortic stenosis, epidemiology, etiology, diagnostics, aortic valve calcification, bicuspid aortic valve, assessment of aortic stenosis severity, echocardiography, computed tomography.
For citation: Sinkov A.V. Modern approaches to aortic stenosis diagnostics // RMJ. Medical Review. 2018. № 8(I). P. 19–23.