Document Detail


Comparison of dual-source computed tomography for the quantification of the aortic valve area in patients with aortic stenosis versus transthoracic echocardiography and invasive hemodynamic assessment.
MedLine Citation:
PMID:  19932793     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared the measurements of the aortic valve area (AVA) using dual-source computed tomography (DSCT) in patients with mid to severe aortic stenosis to measurements using transthoracic echocardiography (TTE) and invasive hemodynamic assessment. A total of 50 patients (mean age 73 +/- 10 years) with suspected aortic stenosis were included. The computed tomographic data were acquired using DSCT with standardized scan parameters (2 x 64 x 0.6 mm collimation, 330-ms rotation, 120-kV tube voltage, 560 mA/rot tube current). After injection of 35 ml contrast agent (flow rate 5 ml/s), a targeted volume data set, ranging from the top of the leaflets to the infundibulum, was acquired. Ten cross-sectional data sets (slice thickness 1 mm, no overlap, increment 0.6 mm) were reconstructed during systole in 5% increments of the R-R interval. The AVA determined in systole by planimetry was compared to the calculated AVA values using the continuity equation on TTE and the Gorlin formula on catheterization. DSCT allowed the planimetry of the AVA in all patients. The mean AVA using DSCT was 1.16 +/- 0.47 cm(2) compared to a mean AVA of 1.04 +/- 0.45 cm(2) using TTE and 1.06 +/- 0.45 cm(2) using catheterization, with a significant correlation between DSCT/TTE (r = 0.93, p <0.001) and DSCT/cardiac catheterization (r = 0.97, p <0.001). However, DSCT demonstrated a slight, but significant, overestimation of the AVA compared to TTE (+0.12 +/- 0.17 cm) and catheterization (+0.10 +/- 0.12 cm(2)). In conclusion, DSCT permits one to assess the AVA with a high-image quality and diagnostic accuracy compared to TTE and invasive determination.
Authors:
Dieter Ropers; Ulrike Ropers; Mohammed Marwan; Titiano Schepis; Tobias Pflederer; Martin Wechsel; Lutz Klinghammer; Frank A Flachskampf; Werner G Daniel; Stephan Achenbach
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1561-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine 2 (Cardiology - Angiology), University of Erlangen-Nuremberg, Nuremberg, Germany. dieter.ropers@uk-erlangen.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Valve / physiopathology,  radiography*,  ultrasonography*
Aortic Valve Stenosis / diagnosis,  physiopathology,  radiography*,  ultrasonography*
Contrast Media
Echocardiography*
Female
Heart Catheterization / methods
Hemodynamics*
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Severity of Illness Index
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Contrast Media

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