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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Description of stages of aortic stenosis

Description of stages of aortic stenosis
Stage Description and symptoms Valve anatomy Hemodynamics

LVEF
Ca++ Mobility Key criteria Additional measures
A At risk (asymptomatic) + Normal Aortic Vmax <2 m/s – Normal
B Progressive (asymptomatic) ++ ↓ to ↓↓

Mild AS: Aortic Vmax 2.0 to 2.9 m/s or mean ΔP <20 mmHg

Moderate AS: Aortic Vmax 3.0 to 3.9 m/s or mean ΔP 20 to 39 mmHg		 – Normal
C1 Asymptomatic severe AS with normal LVEF +++ ↓↓↓

Aortic Vmax ≥4 m/s or mean ΔP 40 mmHg (severe)
Aortic Vmax ≥5 m/s or mean ΔP ≥60 mmHg (very severe)

AVA typically ≤1 cm2

(or AVAi ≤0.6 cm2/m2)

 Normal
C2 Asymptomatic severe AS with low LVEF +++ ↓↓↓ Aortic Vmax ≥4 m/s or mean ΔP ≥40 mmHg (severe)

AVA typically ≤1 cm2

(or AVAi ≤0.6 cm2/m2)

 <50%
D1 Symptomatic severe high-gradient AS ++++ ↓↓↓↓ Aortic Vmax ≥4 m/s or mean ΔP ≥40 mmHg

AVA typically ≤1 cm2

(or AVAi ≤0.6 cm2/m2)

but may be larger with mixed AS/AR

 Normal or ↓
D2 Symptomatic severe low-gradient AS with low LVEF ++++ ↓↓↓↓

Resting AVA ≤1 cm2 with aortic Vmax <4 m/s or mean ΔP <40 mmHg

 Dobutamine stress shows AVA ≤1 cm2 with Vmax ≥4 m/s at any flow rate <50%
D3 Symptomatic severe low-gradient AS with normal LVEF ++++ ↓↓↓↓

AVA ≤1 cm2 with aortic Vmax <4 m/s or mean ΔP <40 mmHg

Measured when the patient is normotensive (systolic BP <140 mmHg)

Indexed AVA ≤0.6 cm2/m2 and stroke volume index <35 mL/m2

 Normal
Ca++: calcification; LVEF: left ventricular ejection fraction; +: present, with severity indicated by number of symbols; Vmax: maximum transvalvular aortic velocity; ↓: decreased, with degree indicated by number of arrows; AS: aortic stenosis; ΔP: pressure gradient; AVA: aortic valve area; AVAi: valve area indexed for body surface area; AR: aortic regurgitation; BP: blood pressure.
Reproduced with permission from: Otto CM, Nishimura RA. New ACC/AHA valve guidelines: aligning definitions of aortic stenosis severity with treatment recommendations. Heart 2014; 100:902. Copyright © 2014 BMJ Publishing Group Ltd and British Cardiovascular Society. All rights reserved.
Graphic 95224 Version 9.0

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