Document Detail


Discrepancy between gradients derived by cardiac catheterization and by Doppler echocardiography in aortic stenosis: how often does pressure recovery play a role?
MedLine Citation:
PMID:  19840067     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Studies have shown very good correlation between Doppler-derived gradients and gradients obtained by cardiac catheterization (cath) in aortic stenosis (AS). However, the phenomenon of pressure recovery may lead to significant overestimation of aortic valve (AV) gradients by Doppler echocardiography (echo). We hypothesized that echo-derived gradients will be higher in mild-moderate AS because of pressure recovery. We studied 94 patients who had echo and cardiac caths in a span of 1 week. The mean age was 72 +/- 13 years, 54% males, 79% had coronary artery disease, and the mean left ventricular ejection fraction was 45 +/- 22%. The mean cardiac output and cardiac indices were 5.1 +/- 1.4/2.7 +/- 0.6 (l/mt), (l/m(2)), respectively. For those with mild AS, echo overestimated gradients in 9.5% of patients (4/42) by an average of 19 mmHg, thus misclassifying the degree of stenosis. In those with moderate AS, 14% (3/21) were misclassified as severe AS (gradient overestimation by an average of 13.6 mmHg). In those with severe AS, echo underestimated gradients in 13% (4/31) by an average of 22.7 mmHg. The aorta at the sinotubular junction was 2.8 cm in those patients with mild AS in whom gradients were overestimated by more than 20 mmHg compared to a sinotubular junction diameter of 3.12 cm in those with mild AS and no overestimation of gradients. The AV area/aortic root ratio was 0.4 in those with mild AS and 0.2 in those with severe AS (P < 0.05).
Authors:
Anoop C Parameswaran; Dave Reisner; Aman Amanullah
Related Documents :
10147617 - Anatomic and functional assessment of stenosis severity with intravascular ultrasound i...
856737 - A physical model of time-dependent flow in the human air passages.
15974527 - High concordance of invasive and echocardiographic mean pressure gradients in patients ...
7494657 - Hemodynamic changes in hh stage 34 chick embryos after treatment with all-trans-retinoi...
7066157 - Prognosis of treated hypertension 1951-1981.
6349747 - Bilateral lesions of the fastigial nucleus prevent the recovery of blood pressure follo...
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  26     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2010-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-5; quiz 999     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PA, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve Stenosis / diagnosis*
Blood Pressure Determination / methods*
Diagnosis, Computer-Assisted / methods*
Echocardiography, Doppler / methods*
Female
Heart Catheterization / methods*
Humans
Male
Reproducibility of Results
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Continuing medical education program in echocardiography.
Next Document:  Left ventricular end-systolic stress in young adults: distribution, risk factors, and relation to ca...