{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:26:19Z","timestamp":1767831979895,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In view of inconsistencies in threshold values of severe aortic stenosis (AS) hemodynamic indices, it is unclear what is the relative contribution of each variable in a binary classification of AS based on aortic valve replacement (AVR) indication. We aimed to assess relative discriminative value and optimal threshold of each constituent hemodynamic parameter for this classification and confirm additional prognostic value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Echocardiography studies of 168 patients with \u2265 moderate AS were included. AS types were dichotomized into Group\u2010A, comprising moderate and Normal\u2010Flow Low\u2010Gradient (NFLG), and Group\u2010B, comprising High\u2010Gradient(HG), Low Ejection Fraction Low\u2010Flow Low\u2010Gradient(Low EF\u2010LFLG), and Paradoxical Low\u2010Flow Low\u2010Gradient(PLFLG) AS. Aortic valve area (AVA), Doppler velocity index (DVI), peak aortic velocity, mean gradient, stroke volume index and transaortic flow rate(TFR) were assessed for A\/B Group discrimination value and optimal thresholds were determined. Dichotomized values were assessed for predictive value for AVR or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>C\u2010statistic values for binary AS classification was .74\u2013.9 for the tested variables. AVA and DVI featured the highest score, and SVI the lowest one. AVA\u2264.81 cm<jats:sup>2<\/jats:sup> and DVI\u2264.249 had 87.6% and 86% respective sensitivity for Group B patients, and a similar specificity of 80.9%. During a mean follow\u2010up of 9.1\u00b110.1 months, each of the tested dichotomized variables except for SVI predicted AVR or death on multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An AVA value \u2264.81 cm<jats:sup>2<\/jats:sup> or a DVI \u2264 .249 threshold carry the highest discriminative value for severe AS in patients with aortic stenosis, translating into an independent prognostic value, and can be helpful in making clinical decisions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15241","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T04:20:09Z","timestamp":1638418809000},"page":"2016-2024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Severe aortic stenosis echocardiographic thresholds revisited"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4164-4972","authenticated-orcid":false,"given":"Shmuel","family":"Schwartzenberg","sequence":"first","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mordehay","family":"Vatury","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Wiessman","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alon","family":"Shechter","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Morelli","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadas","family":"Ofek","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirit","family":"Kazum","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Kornowski","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Sagie","sequence":"additional","affiliation":[{"name":"The Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel affiliated with the Sackler Faculty of Medicine Tel\u2010Aviv University  Tel Aviv 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