The diagnostic role of "acceleration time" measurement in patients with classical low flow low gradient aortic stenosis with reduced left ventricular ejection fraction.

Autor: Sancar KM; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey. drkadik@gmail.com.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey. drkadik@gmail.com., Guler GB; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey., Tanboga HI; Deparment of Cardiology, Nisantası University Faculty of Medicine, Istanbul, Turkey., Cansever AT; Deparment of Radiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey., Demir AR; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey., Guler A; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey., Tekin M; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey., Uygur B; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey., Birant A; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey., Avci Y; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey., Guler E; Deparment of Cardiology, Istanbul Medipol University, Istanbul, Turkey., Erturk M; Deparment of Cardiology, Mehmet Akif Ersoy Cardiothoracic and Vascular Surgery Training and Research Hospital, Istanbul, Turkey. drerturk@gmail.com.; Deparment of Cardiology, University Of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Turgut Ozal Bulvari No:11, 34303, Kucukcekmece/Istanbul, Turkey. drerturk@gmail.com.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2023 Mar; Vol. 39 (3), pp. 481-489. Date of Electronic Publication: 2022 Nov 17.
DOI: 10.1007/s10554-022-02745-2
Abstrakt: Purpose: In our study, we aimed to assess the role of acceleration time (AT), ejection time (ET), and AT/ET ratio to distinguish between true and pseudo severe AS in patients with classical low flow-low gradient (LF-LG) aortic stenosis (AS) with reduced left ventricular ejection fraction (LVEF).
Methods: Sixty-seven classical LF-LG AS with reduced LVEF patients who underwent dobutamine stress echocardiography (DSE) were included in the study. According to DSE results, all patients were divided into two groups; true AS and pseudo severe AS. Aortic valve calcium score was measured in patients with inconclusive DSE results. AT and other ejection dynamics (ET and AT/ET) were calculated by taking baseline echocardiographic records into account for all patients. The predictive power of AT and other ejection dynamics were evaluated to estimate true and pseudo severe AS.
Results: According to DSE results, out of 67 patients, 44 (65.7%) was diagnosed as true severe AS. There was a statistically significant relation between baseline AT and true AS [adjusted OR 4.47 (95% CI 1.93-10.4), p = 0.001]. The best cutoff value of AT was measured as 100 msec according to the Youden index. This value had a sensitivity value of 77%, specificity value of 87%, positive predictive value of 92%, and a negative predictive value of 67%.
Conclusion: The measurement of AT can predict the DSE outcome and can be used for diagnostic purposes to distinguish between true and pseudo severe AS in classical LF-LG AS patients with reduced LVEF.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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