{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T03:55:23Z","timestamp":1781582123156,"version":"3.54.5"},"reference-count":55,"publisher":"Termedia Sp. z.o.o.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesiol Intensive Ther"],"abstract":"<jats:p>Aortic stenosis (AS) causes left ventricular outflow obstruction. Severe AS has major haemodynamic implications in critically ill patients, in whom increased cardiac output and oxygen delivery are often required. &lt;br \/&gt;\nTransthoracic echocardiography (TTE) plays a\u00a0key role in the AS severity grading. In this review, we will give an overview of how to use the simplified Bernoulli equation to convert the echo Doppler measured velocities (cm s-1) to AS peak and mean gra\u00addient (mm Hg) and how to calculate the aortic valve area (AVA), using the continuity equation, based on the principle of preservation of flow. TTE allows quantification of compensatory left ventricular (LV) hypertrophy, assessment of LV systolic function, and determination of LV diastolic function and LV loading. &lt;br \/&gt;\nSubsequently, the obtained results from the TTE study need to be integrated to establish the AS severity grading. The pitfalls of echocardiographic AS severity assessment are explained, and how to deal with inconsistency between AVA and mean gradient. &lt;br \/&gt;\nThe contribution of transoesophageal echocardiography, low-dose dobutamine stress echo (in case of low-flow low-gradient AS), echocardiography strain imaging, cardiac magnetic resonance imaging, cardiac multidetector computed tomography and the relatively new concept of Flow Pressure Gradient Classification to the work-up for aortic stenosis is discussed.&lt;br \/&gt;\nFinally, the treatment of AS is overviewed. Elective aortic valve replacement is indicated in patients with severe symptomatic AS. In the ICU, afterload reduction by vasodilator therapy and treatment of pulmonary and venous congestion by diuretics could be considered.<\/jats:p>","DOI":"10.5114\/ait.2021.104550","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T20:18:53Z","timestamp":1620332333000},"page":"37-54","source":"Crossref","is-referenced-by-count":6,"title":["Comprehensive assessment of the aortic valve in critically ill patients for the non-cardiologist. Part I: Aortic stenosis of the native valve"],"prefix":"10.5114","volume":"53","author":[{"given":"Jeroen","family":"Walpot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy L.","family":"Vermeiren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Al Mafragi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"L.N.G. Malbrain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"ref-1379929","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.015"},{"key":"ref-1379930","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.66.5.1105"},{"key":"ref-1379931","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)91081-R"},{"key":"ref-1379932","first-page":"643","article-title":"Rheumatic fever & rheumatic heart disease: the last 50 years","volume":"137","author":"Kumar RK","year":"2013","unstructured":"Kumar RK, Tandon R. Rheumatic fever & rheumatic heart disease: the last 50 years. Indian J Med Res 2013; 137: 643-658. doi: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23703332.","journal-title":"Indian J Med Res"},{"key":"ref-1379933","first-page":"229","author":"Otto CM","unstructured":"Otto CM. Textbook of Clinical Echocardiography. W.B. Saunders Company; 2000: 229-269."},{"key":"ref-1379934","article-title":"Bicuspid aortic valve","author":"Mubarik A","year":"2020","unstructured":"Mubarik A, Law MA. Bicuspid aortic valve; 2020. Available at: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30480953."},{"key":"ref-1379935","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.9.1074"},{"key":"ref-1379936","doi-asserted-by":"publisher","DOI":"10.4065\/74.1.14"},{"key":"ref-1379937","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.65.4.709"},{"key":"ref-1379938","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60540-0"},{"key":"ref-1379939","volume-title":"Lea & Febiger","author":"Hatle L","year":"1985","unstructured":"Hatle L, Aangelsen B. Doppler ultrasound in cardiology: phisical principles and clinical application. Lea & Febiger; 1985."},{"key":"ref-1379940","first-page":"103","article-title":"The echo manual","author":"Oh JK","year":"1999","unstructured":"Oh JK, Seward JB, Tajik JA. The echo manual. Lippincott Williams & Wilkins; 1999: 103-132.","journal-title":"Lippincott Williams & Wilkins;"},{"key":"ref-1379941","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00066-2"},{"key":"ref-1379942","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02764-X"},{"key":"ref-1379943","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1161\/01.CIR.78.2.435","article-title":"Experimental validation of Doppler echocardiographic measurement of volume flow through the stenotic aortic valve","volume":"78","author":"Otto C","year":"1988","unstructured":"Otto C, Pearlman A, Gardner C. Experimental validation of Doppler echocardiographic measurement of volume flow through the stenotic aortic valve. Circulation 1988; 78: 435-441.","journal-title":"Circulation"},{"key":"ref-1379944","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1161\/01.CIR.72.4.810","article-title":"Noninvasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two-dimensional echocardiography","volume":"72","author":"Skjaerpe T","year":"1985","unstructured":"Skjaerpe T, Hegrenaes L, Hatle L. Noninvasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two-dimensional echocardiography. Circulation 1985; 72: 810-818.","journal-title":"Circulation"},{"key":"ref-1379945","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jen254"},{"key":"ref-1379946","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet284"},{"key":"ref-1379947","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2009.02.007"},{"key":"ref-1379948","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"ref-1379949","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000031"},{"key":"ref-1379950","doi-asserted-by":"publisher","DOI":"10.5603\/AIT.a2015.0074"},{"key":"ref-1379951","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90585-6"},{"key":"ref-1379952","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2020.07.002"},{"key":"ref-1379953","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeaa220"},{"key":"ref-1379954","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.09.030"},{"key":"ref-1379955","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.11.078"},{"key":"ref-1379956","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2009.190942"},{"key":"ref-1379957","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2014.9.2.92"},{"key":"ref-1379958","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12978-9"},{"key":"ref-1379959","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.198853"},{"key":"ref-1379960","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002310"},{"key":"ref-1379961","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4037\/ajcc2005.14.1.40","article-title":"Comparison of cardiac output determined by bioimpedance, thermodilution, and the Fick method","volume":"14","author":"Engoren M","year":"2005","unstructured":"Engoren M, Barbee D. Comparison of cardiac output determined by bioimpedance, thermodilution, and the Fick method. Am J Crit Care 2005; 14: 40-45. doi: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15608107.","journal-title":"Am J Crit Care"},{"key":"ref-1379962","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0002-8703(51)90002-6","article-title":"Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves, and central circulatory shunts","volume":"41","author":"Gorlin R","year":"1951","unstructured":"Gorlin R, Gorlin SG. Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves, and central circulatory shunts. Am Hear J 1951; 41: 1-29.","journal-title":"Am Hear J"},{"key":"ref-1379963","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.63.5.1050"},{"key":"ref-1379964","doi-asserted-by":"publisher","DOI":"10.5603\/AIT.a2017.0072"},{"key":"ref-1379965","doi-asserted-by":"publisher","DOI":"10.5603\/AIT.a2017.0068"},{"key":"ref-1379966","doi-asserted-by":"publisher","DOI":"10.5603\/AIT.2014.0056"},{"key":"ref-1379967","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.08.1621"},{"key":"ref-1379968","doi-asserted-by":"publisher","DOI":"10.1080\/10976640701545479"},{"key":"ref-1379969","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-009-9464-z"},{"key":"ref-1379970","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-020-00632-0"},{"key":"ref-1379971","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315211"},{"key":"ref-1379972","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.11.032"},{"key":"ref-1379973","first-page":"103","volume-title":"The Echo Manual","author":"Oh JK","year":"1999","unstructured":"Oh JK, Seward JB, Tajik JA. The echo manual. In: The Echo Manual. 2nd etiton. Lippincott Williams & Wilkins; 1999: 103-132.","edition":"2nd etiton"},{"issue":"26","key":"ref-1379974","article-title":"Aortic valve stenosis: evaluation and management of patients with discordant grading","volume":"15","author":"Messika-Zeitoun D","year":"2018","unstructured":"Messika-Zeitoun D, Lloyd G. Aortic valve stenosis: evaluation and management of patients with discordant grading. E-journal Cardiol Pract 2018; 15(26).","journal-title":"E-journal Cardiol Pract"},{"key":"ref-1379975","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"ref-1379976","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003695"},{"key":"ref-1379977","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht094"},{"key":"ref-1379978","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.054"},{"key":"ref-1379979","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.000000000002426"},{"key":"ref-1379980","doi-asserted-by":"publisher","DOI":"10.4250\/jcvi.2018.26.e9"},{"key":"ref-1379981","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcy088"},{"key":"ref-1379982","volume-title":"StatPearls [Internet]","author":"Kurapati R","year":"2020","unstructured":"Kurapati R, Heaton J, Lowery DR. Atrial kick. In: StatPearls [Internet] 2020. Available at: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29494028."},{"key":"ref-1379983","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023997"}],"container-title":["Anaesthesiology Intensive Therapy"],"original-title":[],"link":[{"URL":"https:\/\/www.ait-journal.com\/pdf-133471-121894","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ait-journal.com\/pdf-133471-121894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T10:59:37Z","timestamp":1743073177000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ait-journal.com\/Comprehensive-assessment-of-the-aortic-valve-in-critically-ill-patients-for-the-non,133471,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,31]]},"references-count":55,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"alternative-id":["133471"],"URL":"https:\/\/doi.org\/10.5114\/ait.2021.104550","relation":{},"ISSN":["1642-5758","1731-2531"],"issn-type":[{"value":"1642-5758","type":"print"},{"value":"1731-2531","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,31]]}}}