{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:53:09Z","timestamp":1779195189053,"version":"3.51.4"},"reference-count":35,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Echocardiography is the reference standard for grading aortic stenosis (AS); however, it yields discordant severity estimates in up to 40% of patients. Multidetector computed tomography (MDCT)-derived methods for calculating aortic valve area (AVA) may improve diagnostic concordance, but their diagnostic performance, validation against invasive hemodynamics, and the influence of left ventricular outflow tract (LVOT) morphology on severity grading remain insufficiently investigated. Methods: We retrospectively analyzed 307 patients with normal-flow, high-gradient calcific AS who underwent echocardiography, MDCT, and cardiac catheterization. AVA was calculated using (1) echocardiographic LVOT diameter, (2) hybrid Doppler\u2013MDCT planimetric LVOT area, and (3) corrected echocardiographic LVOT diameter (\u00d71.13). Agreement, correlation, and diagnostic performance were assessed using Bland\u2013Altman analysis, Pearson correlation, ROC analysis, and McNemar\u2019s test. Subgroups defined by diagnostic concordance and MDCT-derived LVOT size were compared using ANOVA. Results: Hybrid AVA showed a strong correlation with echocardiographic AVA (r = 0.749, p &lt; 0.001), with a mean difference of +0.11 \u00b1 0.15 cm2. Both methods demonstrated similar relationships with invasive and non-invasive hemodynamic markers of AS severity. When combined with echocardiography, the hybrid method increased concordant classification of severe AS by 8%. In contrast, corrected AVA performed significantly worse, leading to more discordant classifications. LVOT size was significantly associated with variability in AVA and Doppler velocity index, independent of flow status. Conclusions: Hybrid MDCT-derived AVA provides diagnostic performance equivalent to echocardiography and improves concordance in selected patients. LVOT size influences key echocardiographic parameters and may warrant tailored diagnostic thresholds.<\/jats:p>","DOI":"10.3390\/diagnostics15243233","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T15:53:46Z","timestamp":1765986826000},"page":"3233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multidetector Computed Tomography and Aortic Stenosis: The Emerging Potential of Bridging Morphology and Severity Grading"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5192-6280","authenticated-orcid":false,"given":"Gabriele","family":"Cordoni","sequence":"first","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Di Paolantonio","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Savo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9390-7263","authenticated-orcid":false,"given":"Dan Alexandru","family":"Cozac","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"},{"name":"Physiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Lassandro","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Andolina","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"De Conti","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Ternacle","sequence":"additional","affiliation":[{"name":"Haut-Leveque Cardiologic Hospital, Bordeaux University, 33600 Pessac, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1886-9826","authenticated-orcid":false,"given":"Raffaella","family":"Motta","sequence":"additional","affiliation":[{"name":"Radiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3317-7342","authenticated-orcid":false,"given":"Valeria","family":"Pergola","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoracic-Vascular and Public Health Department, Padova University Hospital, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4635","DOI":"10.1093\/eurheartj\/ehaf194","article-title":"2025 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"46","author":"Praz","year":"2025","journal-title":"Eur. 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