| Autor: |
Philippe, Unger, Chantal, Dedobbeleer, Eric, Stoupel, Nicolas, Preumont, Jean-François, Argacha, Guy, Berkenboom, Guy, Van Camp |
| Rok vydání: |
2014 |
| Předmět: |
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| Zdroj: |
The Journal of heart valve disease. 23(3) |
| ISSN: |
0966-8519 |
| Popis: |
Estimation of stroke volume in the left ventricular outflow tract (LVOT) is a main limitation to aortic valve area (AVA) calculation by echocardiography when using the continuity equation. In this study, the hypothesis was tested that a hybrid method using thermodilution-derived cardiac output measurement and simultaneous Doppler estimation of the systolic ejection period and transvalvular aortic velocities could be used to accurately assess AVA in patients with low-gradient severe aortic stenosis (AS).Eighteen patients with low mean gradient (40 mmHg) and nine patients with conventionally defined (or = 40 mmHg) severe AS (1 cm2), as assessed by the echocardiographic continuity equation (baseline echocardiography), underwent catheterization and simultaneous Doppler recording of trans-aortic velocities.The mean pressure gradient was slightly lower by Doppler in the catheterization laboratory (35.8 +/-15.7 mmHg) compared to baseline echocardiography (37.4 +/- 15.2 mmHg) and invasive (38.5 +/- 16.6 mmHg) measurements (both p0.05). The AVA values were 0.72 +/- 0.12 cm2 during baseline echocardiography, 0.74 +/- 0.14 cm2 by catheterization, and 0.71 +/- 0.14 cm2 by the hybrid method (bias -0.01 +/- 0.11 cm2 and -0.02 +/- 0.08 cm2, versus echocardiography and catheterization, respectively; both p = NS).The hybrid method is reasonably accurate in assessing AVA in patients with low-gradient severe AS. Although the continuity equation should be used in routine clinical practice in most patients, this method could serve as an alternative when the LVOT diameter and/or velocities seem questionable. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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