{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:04:32Z","timestamp":1767773072505,"version":"build-2065373602"},"reference-count":86,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Aortic stenosis (AS) is the most prevalent degenerative valvular disease in western countries. Transthoracic echocardiography (TTE) is considered, nowadays, to be the main imaging technique for the work-up of AS due to high availability, safety, low cost, and excellent capacity to evaluate aortic valve (AV) morphology and function. Despite the diagnosis of AS being considered straightforward for a very long time, based on high gradients and reduced aortic valve area (AVA), many patients with AS represent a real dilemma for cardiologist. On the one hand, the acoustic window may be inadequate and the TTE limited in some cases. On the other hand, a growing body of evidence shows that patients with low gradients (due to systolic dysfunction, concentric hypertrophy or coexistence of another valve disease such as mitral stenosis or regurgitation) may develop severe AS (low-flow low-gradient severe AS) with a similar or even worse prognosis. The use of complementary imaging techniques such as transesophageal echocardiography (TEE), multidetector computed tomography (MDTC), or cardiac magnetic resonance (CMR) plays a key role in such scenarios. The aim of this review is to summarize the diagnostic challenges associated with patients with AS and the advantages of a comprehensive multimodality cardiac imaging (MCI) approach to reach a precise grading of the disease, a crucial factor to warrant an adequate management of patients.<\/jats:p>","DOI":"10.3390\/jcdd11060162","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T09:04:25Z","timestamp":1716455065000},"page":"162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic Challenges in Aortic Stenosis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9628-8536","authenticated-orcid":false,"given":"Andr\u00e9","family":"Gonz\u00e1lez-Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Pazos-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Eugenio","family":"Calvo-Iglesias","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-853X","authenticated-orcid":false,"given":"Tatiana Mallely","family":"Matajira-Ch\u00eda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Bilbao-Quesada","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Blanco-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carina","family":"Gonz\u00e1lez-R\u00edos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Casti\u00f1eira-Busto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Barreiro-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"\u00cd\u00f1iguez-Romo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: A population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1161\/CIRCULATIONAHA.119.041080","article-title":"Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey","volume":"140","author":"Iung","year":"2019","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.rccl.2020.07.002","article-title":"Cribado poblacional de estenosis a\u00f3rtica: Prevalencia y perfil de riesgo","volume":"56","author":"Sequeiros","year":"2021","journal-title":"REC CardioClinics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1093\/ehjci\/jew335","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: A focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"18","author":"Baumgartner","year":"2017","journal-title":"Eur. 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