P1370 Correlation of aortic stenosis by integrated transthoracic and transesophageal echocardiography with calcium score

Autor: Shirit Kazum, Hadas Ofek, M Vaturi, Ran Kornowski, M Nassar, Idit Yedidya, Alik Sagie, Yaron Shapira, Shmuel Schwartzenberg, Ashraf Hamdan, Daniel Monakier
Rok vydání: 2020
Předmět:
Zdroj: European Heart Journal - Cardiovascular Imaging. 21
ISSN: 2047-2412
2047-2404
DOI: 10.1093/ehjci/jez319.805
Popis: Funding Acknowledgements None BACKGROUND Aortic stenosis (AS) classification depends on left-ventricular ejection-fraction (LVEF PURPOSE We investigated correlation of AVC with dichotomous AS grouping by Integrated TTE + TEE vs TTE only. METHODS 64 TAVI candidates underwent sequential TTE and TEE, of which 24 underwent coronary CT within 4 months. Based on recommended conservative vs invasive treatment implication (A/B respectively), AS types were aggregated separately by TTE or Integrated TTE-TEE into two groups: Group-A (Moderate AS and Normal-Flow Low-Gradient), and Group-B (High-Gradient, Low-EF Low-Flow Low-Gradient, and Paradoxical Low-Flow Low-Gradient). Continuous and dichotomous AVC correlation (cutoffs based on guidelines) with echo binary classification was then determined. RESULTS Patients were 81.1(77.3-84.6) years old, 18(48.6%) were women, and had LVEF of 60% (49-65). AVC-score distribution in the two AS A/B Groups by two echo modalities is presented in the boxplot Figure. Only classification by TTE held discriminative accuracy in A/B grouping, with Area-Under-Curve of 0.736 (CI 0.57-0.9), and optimal threshold value of 1946 AU having 77% sensitivity and 74% specificity. Compared with AVC dichotomous classification, integrated TTE + TEE upgraded AS class (from A to B) in 5/6 (83.3%) patients vs 12/18 (66.7%) in which it downgraded AS class from B to A. CONCLUSIONS Aortic valve calcification correlates well with AS class dichotomized by operative implication through conventional TTE but not through integrated TTE + TEE. Our preliminary results appear to be caused by initial selection bias of patients in whom coronary CT performance was deemed to be justified by the treating physician rather than reflect a true better correlation between CT score and AS assessment by TTE vs by integrated TTE + TEE. Abstract P1370 Figure.
Databáze: OpenAIRE