Aortic sclerosis echocardiography and ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Aortic sclerosis is defined based on transthoracic echocardiographic findings which include irregular leaflet thickening and focal valve thickening with associated increase in echogenicity.[1][2][3][4]

Echocardiographic Features

  • Focal areas of valve thickening with associated increase in echogenicity is the hallmark of aortic sclerosis, as opposed to diffuse thickening observed as a part of normal aging
  • Aortic side of the valve in the center of the valve cusp is commonly affected
  • Commissural areas are spared
  • Calcific nodules at the base of leaflets
  • Leaflet mobility is normal

Hemodynamic Parameters

  • Valvular hemodynamic parameters are normal
  • Normal trans-valvular Doppler velocity (Vmax <2 m/s)
  • Although, the valve is calcified, the jet flow velocity of ≤ 2.5 m per sec without a significant gradient across the valve

Progression to Aortic Stenosis

Echocardiographic indicators of progression of aortic sclerosis to aortic stenosis include:

  • Restricted leaflet mobility
  • Increased echogenicity suggestive of increase leaflet calcification
  • Increase in jet flow velocity across the valve

References

  1. Freeman RV, Otto CM (2005). "Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies". Circulation. 111 (24): 3316–26. doi:10.1161/CIRCULATIONAHA.104.486738. PMID 15967862. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  2. Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS (1999). "Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly". The New England Journal of Medicine. 341 (3): 142–7. doi:10.1056/NEJM199907153410302. PMID 10403851. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  3. Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM (1997). "Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study". Journal of the American College of Cardiology. 29 (3): 630–4. PMID 9060903. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  4. Gharacholou SM, Karon BL, Shub C, Pellikka PA (2011). "Aortic valve sclerosis and clinical outcomes: moving toward a definition". The American Journal of Medicine. 124 (2): 103–10. doi:10.1016/j.amjmed.2010.10.012. PMID 21295189. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)

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