Multi-modality imaging in aortic stenosis: an EACVI clinical consensus document
Open accessAbstract
In this EACVI clinical scientific update, we will explore the current use of multi-modality imaging in the diagnosis, risk stratification, and follow-up of patients with aortic stenosis, with a particular focus on recent developments and future directions. Echocardiography is and will likely remain the key method of diagnosis and surveillance of aortic stenosis providing detailed assessments of valve haemodynamics and the cardiac remodelling response. Computed tomography (CT) is already widely used in the planning of transcutaneous aortic valve implantation. We anticipate its increased use as an anatomical adjudicator to clarify disease severity in patients with discordant echocardiographic measurements. CT calcium scoring is currently used for this purpose; however, contrast CT techniques are emerging that allow identification of both calcific and fibrotic valve thickening. Additionally, improved assessments of myocardial decompensation with echocardiography, cardiac magnetic resonance, and CT will become more commonplace in our routine assessment of aortic stenosis. Underpinning all of this will be widespread application of artificial intelligence. In combination, we believe this new era of multi-modality imaging in aortic stenosis will improve the diagnosis, follow-up, and timing of intervention in aortic stenosis as well as potentially accelerate the development of the novel pharmacological treatments required for this disease.
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Assessing aortic valve calcification using a calcium score derived from non-contrast CT has proven valuable.
“In such cases, assessing aortic valve calcification using a calcium score derived from non-contrast computed tomography (CT) has proven to be valuable4–6.”
From Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort (2025) · cites this paper as [6]
Cites
2021 ESC/EACTS Guidelines for the management of valvular heart disease
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Self-citationThe Complex Nature of Discordant Severe Calcified Aortic Valve Disease Grading
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Self-citationComputed Tomography Aortic Valve Calcium Scoring in Patients With Aortic Stenosis
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Self-citationContrast-enhanced computed tomography assessment of aortic stenosis
Cartlidge, T. R., Bing, R., Kwiecinski, J., Guzzetti, E., Pawade, T. A., Doris, M. K., Adamson, P. D., Massera, D., Lembo, M., Peeters, F. E. C. M., et al. (2021) · Heart · doi:10.1136/heartjnl-2020-318556 · Cited by 82 · see citing works
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Springhetti, P., Abdoun, K., & Clavel, M.-A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13144237 · Cited by 24 · see citing works
Self-citationCharacterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort
Lorenzatti, D., Filtz, A., Pina, P., Geers, J., Gilman, J., Daich, J., Ippolito, P., Aftab, A., Schenone, A. L., Gongora, C. A., et al. (2025) · Circulation: Cardiovascular Imaging · doi:10.1161/circimaging.124.017858 · Cited by 7 · see citing works
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- Authors
- Dweck, M. R., Loganath, K., Bing, R., Treibel, T. A., McCann, G. P., Newby, D. E., Leipsic, J., Fraccaro, C., Paolisso, P., Cosyns, B., Habib, G., Cavalcante, J., Donal, E., Lancellotti, P., Clavel, M.-A., Otto, C. M., & Pibarot, P.
- Affiliations
- University of Edinburgh (GB)
- St Bartholomew's Hospital (GB)
- University of Leicester (GB)
- St. Paul's Hospital (CA)
- University of Padua (IT)
- Onze Lieve Vrouwziekenhuis Hospital (BE)
- Universitair Ziekenhuis Brussel (BE)
- Hôpital de la Timone (FR)
- Abbott Northwestern Hospital (US)
- CIC Rennes (FR)
- Centre Hospitalier Universitaire de Liège (BE)
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- University of Washington (US)
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute , 2725 Ch Ste-Foy, Québec, QC G1V 4G5 ,
- Corresponding author
- Dweck, Marc R
- ORCID
- Venue
- European Heart Journal - Cardiovascular Imaging
- Publisher
- Oxford University Press (OUP)
- Published
- 2023-07-03
- Volume
- 24
- Issue
- 11
- Pages
- 1430-1443
- ISSN
- 2047-2404 (ISSN-L)
- 2047-2412
- OpenAlex
- W4382918014
- Cited by
- 79
- References
- 8
- Citations by year
- 2026: 28 · 2025: 32 · 2024: 15 · 2023: 4
- FWCI
- 15.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal - Cardiovascular Imaging (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc)
- UCL Discovery (University College London) (submittedVersion)
- ORBi (University of Liège) (submittedVersion, other-oa)
- Corpus Université Laval (Université Laval) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- British Heart Foundation (CH/09/002/26360, SP/20/3/35123, FS/19/35/34374)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
- Keywords
- aortic stenosis, multi-modality imaging, echocardiography, computed tomography, cardiac magnetic resonance, CT calcium scoring, contrast-enhanced CT, cardiac remodeling, risk stratification, artificial intelligence, valve calcification
- MeSH terms
- Aortic Valve, Aortic Valve Stenosis, Artificial Intelligence, Humans, Consensus, Multimodal Imaging
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