Doppler echocardiography-derived aortic valve area correlated with cardiac catheterization results (r=0.71), with stronger agreement in patients without significant aortic insufficiency (r=0.91).
Observational (n=48)
Does Doppler echocardiography accurately estimate transvalvular pressure gradients and aortic valve area compared to cardiac catheterization in adults with aortic stenosis?
Doppler echocardiography provides a noninvasive method to accurately estimate aortic valve area and transvalvular gradients in adults with aortic stenosis, particularly in those without significant aortic insufficiency.
Effect estimate: r = 0.71
The severity of aortic stenosis was evaluated by Doppler echocardiography in 48 adults (mean age 67 years) undergoing cardiac catheterization. Maximal Doppler systolic gradient correlated with peak to peak pressure gradient (r = 0.79, y = 0.63x + 25.2 mm Hg) and mean Doppler gradient correlated with mean pressure gradient (r = 0.77, y = 0.59x + 10.0 mm Hg) by manometry. The transvalvular pressure gradient is flow dependent, however, and associated left ventricular dysfunction was common in our patients (33%). Thus, of the 32 patients with an aortic valve area less than or equal to 1.0 cm2 at catheterization, 6 (19%) had a peak Doppler gradient less than 50 mm Hg. To take into account the influence of volume flow, aortic valve area was calculated as stroke volume, measured simultaneously by thermodilution, divided by the Doppler systolic velocity integral in the aortic jet. Aortic valve areas calculated by this method were compared with results at catheterization in the total group (r = 0.71). Significant aortic insufficiency was present in 71% of the population. In the subgroup without significant coexisting aortic insufficiency, closer agreement of valve area with catheterization was noted (n = 14, r = 0.91, y = 0.83x + 0.24 cm2). Transaortic stroke volume can be determined noninvasively by Doppler echocardiographic measures in the left ventricular outflow tract, just proximal to the stenotic valve. Aortic valve area can then be calculated as left ventricular outflow tract cross-sectional area times the systolic velocity integral of outflow tract flow, divided by the systolic velocity integral in the aortic jet.(ABSTRACT TRUNCATED AT 250 WORDS)
Otto et al. (1986) conducted an observational in Aortic stenosis (n=48). Doppler echocardiography vs. Cardiac catheterization was evaluated on Correlation of aortic valve area calculated by Doppler echocardiography versus cardiac catheterization (r = 0.71). Doppler echocardiography-derived aortic valve area correlated with cardiac catheterization results (r=0.71), with stronger agreement in patients without significant aortic insufficiency (r=0.91).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: