Heart rate influence on the systolic gradient across the stenotic aortic valve: Theoretical evaluation and implications

Peak systolic gradient across the aortic value, measured invasively or noninvasively is used in many laboratories for estimation of the severity of the stenosis (=actual valve area). This study shows that when cardiac output is normal the gradient across the valve is influenced by heart rate (HR) apart from valve area. A rate‐corrected peak systolic gradient (PSGc) is defined by the formula √PSGc = 0.041 √PSG HR (0.442–0.0014 HR) and its importance for clinical decision making is demonstrated. The significance of bradycardia in the pathogenesis of syncope in aortic stenosis is discussed.