Aortic stenosis (AS) was the most frequent valve disease referred for surgical treatment in developed countries. The management of the disease depends of AS severity. Echocardiography is the mainstay of assessment, and three parameters are recommended for AS severity evaluation: effective orifice area, mean aortic gradient, and peak jet velocity.

Our study was to evaluate acceleration time (AT) and the ratio the AT/ET (ejection time) ratio as diagnostic parameters in AS and to analyse the defining characteristics of the aortic waveform.

Patients with AS were prospectively enrolled. Quantitative echocardiographic Doppler parameters including ejection dynamics (AT, ET, and AT/ET ratio) as well as conventional and clinical parameters were analysed. AT, ET, and AT/ET ratio were calculated in different stages of AS.

Fifty-one patients were included (mean age, 56 years; 54% women), of whom 37 (74%) had severe AS and 14 (26%) patients had moderate AS; AT was higher in patients with higher levels of severity (121 vs. 85 msec, P<0.001), as well as AT/ET ratios (28% vs. 37%, P<0.001) (Table 1). Using a cut-off of 80 msec for AT and 32% for AT/TE, while there were no differences in ET (297 vs. 300ms, P=0.66). Receiver operating characteristic analysis showed that AT and AT/ET ratio could discriminate severe AS, whereas ET could not. We found good correlations between both ejection parameters (AT and AT/ET ratio) and all the usual echocardiographic methods for assessing AS (Fig. 1).

The present study shows that systolic time intervals, particularly AT and AT/ET ratio, are easy and accurate methods that are related to AS severity and could be used as alternatives in the echocardiographic assessment of this disease.