{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:34:24Z","timestamp":1785771264193,"version":"3.56.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Timing of treatment of aortic stenosis (AS) is of key importance. AS severity is currently determined by transthoracic echocardiography (TTE) with a main focus on mean trans\u2010aortic gradients. However, echocardiography has its limitations. The transvalvular flow rate (<jats:italic>Q<\/jats:italic>), is defined as the ratio of stroke volume (SV) to ejection time (ET): <jats:italic>Q<\/jats:italic> = SV\/ET.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To examine the prognostic value of aortic transvalvular flow rate (<jats:italic>Q<\/jats:italic>), in patients with moderate or severe AS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data from 824 patients diagnosed with AS between 2017 and 2020, and followed up until 2022 for four clinical outcomes: mortality, congestive heart failure (CHF), transcatheter aortic valve implantation (TAVI), and surgical aortic valve replacement (SAVR) was used for this retrospective study. Univariate and multivariate regression analyses were performed for the whole cohort and for the moderate AS subgroup, to identify prognostic markers. Kaplan\u2010Meier survival analysis was conducted for different transvalvular flow rates and AS severities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Findings demonstrate that lower <jats:italic>Q<\/jats:italic> is a significant risk factor for all\u2010cause mortality even when adjusted for other echocardiographic and clinical variables. Survival analysis for the composite outcome occurrence (TAVI, SAVR, CHF, or mortality) and mortality showed significant differences between groups stratified by AS severity and <jats:italic>Q<\/jats:italic> (<jats:italic>p<\/jats:italic> value &lt;0.0001). Specifically, <jats:italic>Q<\/jats:italic> was more substantial in the moderate AS group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transvalvular flow rate (<jats:italic>Q<\/jats:italic>) is independently prognostic for all\u2010cause mortality. Furthermore, patients with moderate AS and lower <jats:italic>Q<\/jats:italic> should be closely monitored. Flow rate assessment should be integrated into the diagnosis, classification, and prognosis framework for AS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.70077","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T17:15:11Z","timestamp":1737393311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Value of Transvalvular Flow Rate in Aortic Stenosis: Implications for Risk Stratification"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3637-1774","authenticated-orcid":false,"given":"Elad M.","family":"Bar Gil","sequence":"first","affiliation":[{"name":"Joyce and Irving Goldman Medical School, Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruslan","family":"Sergienko","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Biostatistics and Community Health Sciences Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Roguin","sequence":"additional","affiliation":[{"name":"Joyce and Irving Goldman Medical School, Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoham","family":"Birman","sequence":"additional","affiliation":[{"name":"Neuroscience Department Bar\u2010Ilan University  Beer\u2010Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio L.","family":"Kobal","sequence":"additional","affiliation":[{"name":"Cardiology Department Soroka University Medical Center  Beer\u2010Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.119.313067"},{"issue":"10","key":"e_1_2_11_3_1","article-title":"Epidemiology of Aortic Valve Stenosis (AS) and of Aortic Valve Incompetence (AI): Is the Prevalence of AS\/AI Similar in Different Parts of the World?","volume":"18","author":"Ancona R.","year":"2020","journal-title":"e\u2010Journal of Cardiology Practice"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","unstructured":"A.Kanwar J. 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