TY - JOUR
AU1 - Hamadanchi, A.
AU2 - Moradi, B.
AU3 - Bekfani, T.
AU4 - Franz, M.
AU5 - Otto, S.
AU6 - Poerner, T.C.
AU7 - Schulze, P.C.
AU8 - Goebel, B.
AB - Background: It is well acknowledged that evaluation of aortic stenosis (AS) severity should incorporate transvalvular flow by stroke volume index (SVi), mean pressure gradient (MPG) and calculation of aortic valve area index (AVAi). The current guidelines suggest calculating SVi by echocardiography based on the left ventricular outflow tract diameter and Doppler velocity time integral (SVi2D) which encompasses many pitfalls and limitations. We intended to compare three-dimensional echocardiographic derived SVi (SVi3D) to SVi2D, among the patients with invasively proved low-flow AS (LF-AS), in whom this method has not been fully validated yet. Methods: Prospectively, out of 250 consecutive patients with severe AS referred to our institution between August 2015 to October 2016, 40 patients (age 74±11 years, 25, male) with documented LF-AS based on invasive catheter measurements (aortic valve area calculated by Gorlin formula = AVAiinv) were selected based on the following exclusion criteria: significant (more than moderate) aortic and mitral valvular regurgitation and inadequate acoustic window. In addition to conventional 2D and Doppler evaluation of AS, a full-volume 3D data-set of the left ventricle for quantification of left ventricular enddiastolic/-systolic volumes (EDV3D, ESV3D) and ejection fraction (EF3D) was acquired in all patients (Figure 1). Results: Seventeen patients (43%) were classified as LF-LG with reduced ejection fraction (EF) and 23 (57%) as paradoxical LF-LG (pLF-LG) with preserved EF (>50%) (Table1). In both groups, Bland-Altman analysis revealed a better statistical agreement of AVAi3D in comparison to the reference method i.e. AVAiinv. by Gorlin formula (Figure 2, absolute value of differences for AVAiinv vs. AVAi3D 0.05±0.04 cm2, for AVAiinv vs. AVAi2D 0.10±0.08 cm2, p<0.001). Open in new tabDownload slide Conclusions: In our small but selected group of invasively confirmed LF-AS patients, AVAi tended to be more accurately estimated by 3D volumetric derived SVi, compared to Doppler based continuity equation. 3D echocardiographic derived SV should be considered as a surrogate for assessment of SVi in the echocardiographic evaluation of all patients with AS. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.
TI - P2399Applying 3D echocardiography derived stroke volume for quantification of aortic valve area in low-flow aortic stenosis: The superiority of a hybrid approach
JF - European Heart Journal
DO - 10.1093/eurheartj/ehx502.p2399
DA - 2017-08-01
UR - https://www.deepdyve.com/lp/oxford-university-press/p2399applying-3d-echocardiography-derived-stroke-volume-for-hzyXj5N6yA
VL - 38
IS - suppl_1
DP - DeepDyve
ER -