Beyond the Valve Itself: Extra-valvular Phenotyping in Mitral Stenosis: A Novel Pathophysiology-driven Echocardiographic Staging System.

Current guideline-based classifications of mitral stenosis rely primarily on parameters ofvalvular narrowing and its associated clinical symptoms. In recent years, novel phenotyping approaches based on the concept of sequential cardiac chamber involvement have been developed for other cardiovascular conditions, including mitral regurgitation, aortic stenosis, and heart failure with preserved ejection fraction. Similarly, the development of an extra-valvular echocardiographic staging system for mitral stenosis, grounded in the extent of cardiac chamber involvement, appears warranted to improve risk stratification and tailor clinical management.