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Update on imaging aortic stenosis



The Thursday afternoon session at the Euroecho Imaging congress in Leipzig entitled “Update on imaging aortic stenosis (AS)” was very well attended and speakers focused on both the diseased valve and in addition, changes in the left ventricular myocardium.

First, Julian Magne pointed out clinically meaningful parameters for the reaction of the myocardium to AS besides a reduced ejection fraction. In this context especially, global longitudinal strain with a cut off of -12.9% seems to be one of the best parameters for prognosis in patients with asymptomatic AS.

In the second talk, James Moon convinced the audience that inside the left ventricular myocardium of patients with severe AS, both replacement (imaged by late enhancement imaging) and interstitial fibrosis (imaged by T1 mapping) can be visualized by cardiac magnetic resonance imaging.

Next, Marc Dweck gave a very innovative lecture about the role of molecular imaging in AS. He mainly focused on the pathology of the valve and showed that both calcification and inflammation can be detected. He speculated that this might have an impact on future specific treatment.

Last but not least, Philippe Pibarot spoke about the subtype of AS with a low-gradient and low-flow pattern. It has become obvious that this pattern exists in about 15% of all patients with severe AS. Interestingly, these patients seem to have worse outcome compared to the well known high gradient AS patients.

Thus, in conclusion, a very interesting session with clinically important messages.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.