{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:35:12Z","timestamp":1789583712969,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Aortic valve stenosis (AS) is a prevalent and progressive valvular disease that poses significant diagnostic challenges, particularly in low-flow, low-gradient (LF-LG) states. Accurate assessment of AS severity is crucial for timely intervention and improved clinical outcomes. This narrative review critically evaluates the limitations of conventional echocardiographic techniques and explores the role of multimodal imaging\u2014including advanced echocardiography, computed tomography (CT), and cardiac magnetic resonance (CMR)\u2014in enhancing diagnostic accuracy. Special emphasis is placed on the unique challenges of LF-LG AS, where standard Doppler-derived assessments may misclassify disease severity, necessitating a more integrative diagnostic approach. By addressing these key diagnostic uncertainties and proposing a multimodal framework for improved assessment, this review provides a comprehensive update on best practices in AS evaluation, with the goal of optimizing clinical decision making and patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm14041231","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T05:10:22Z","timestamp":1739423422000},"page":"1231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Diagnostic Challenges in the Management of Aortic Valve Stenosis and the Role of Imaging: A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2924-8793","authenticated-orcid":false,"given":"Dimitrios","family":"Karelas","sequence":"first","affiliation":[{"name":"2nd Cardiology Department, \u201cKorgialenio\u2013Benakio\u201d Red Cross Hospital, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9356-5702","authenticated-orcid":false,"given":"Evangelos","family":"Tatsis","sequence":"additional","affiliation":[{"name":"2nd Cardiology Department, \u201cKorgialenio\u2013Benakio\u201d Red Cross Hospital, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0697-6656","authenticated-orcid":false,"given":"Dimitrios","family":"Oikonomidis","sequence":"additional","affiliation":[{"name":"2nd Cardiology Department, \u201cKorgialenio\u2013Benakio\u201d Red Cross Hospital, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2566-7173","authenticated-orcid":false,"given":"Constantinos Hristou","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"2nd Cardiology Department, \u201cKorgialenio\u2013Benakio\u201d Red Cross Hospital, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1136\/heartjnl-2014-307020","article-title":"The modern epidemiology of heart valve disease","volume":"102","author":"Coffey","year":"2016","journal-title":"Heart"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.amjmed.2016.10.005","article-title":"Aortic Stenosis: Pathophysiology, Diagnosis, and Therapy","volume":"130","author":"Joseph","year":"2017","journal-title":"Am. 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