High- Versus Low-gradient Aortic Stenosis: Is Our Evaluation Limited By The Aorto-mitral Angle Identified On Cardiac Computed Tomography?

Introduction: Accurate aortic stenosis (AS) severity assessment is crucial for intervention timing. Aortic valve area (AVA) and Doppler data discordance pose dilemmas in severe AS diagnosis, particularly in low-gradient (LG) AS. We hypothesize that aorto-mitral angle (AMA) is narrower in those with LG AS compared with high-gradient (HG) severe AS. This narrowing of the AMA contributes to Doppler-based max velocity (Vm) and mean gradient (MG) underestimation.