| Impact of pressure recovery on echocardiographic assessment of asymptomatic aortic stenosis: a SEAS substudy. | |
| | |
MedLine Citation:
|
PMID: 20541709 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: The aim of this analysis was to assess the diagnostic importance of pressure recovery in evaluation of aortic stenosis (AS) severity. BACKGROUND: Although pressure recovery has previously been demonstrated to be particularly important in assessment of AS severity in groups of patients with moderate AS or small aortic roots, it has never been evaluated in a large clinical patient cohort. METHODS: Data from 1,563 patients in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study was used. Inner aortic diameter was measured at annulus, sinus, sinotubular junction, and supracoronary level. Aortic valve area index (AVAI) was calculated by continuity equation and pressure recovery and pressure recovery adjusted AVAI (energy loss index [ELI]), by validated equations. Primarily, sinotubular junction diameter was used to calculate pressure recovery and ELI, but pressure recovery and ELI calculated at different aortic root levels were compared. Severe AS was identified as AVAI and ELI < or =0.6 cm(2)/m(2). Patients were grouped into tertiles of peak transaortic velocity. RESULTS: Pressure recovery increased with increasing peak transaortic velocity. Overestimation of AS severity by unadjusted AVAI was largest in the lowest tertile and if pressure recovery was assessed at the sinotubular junction. In multivariate analysis, a larger difference between AVAI and ELI was associated with lower peak transaortic velocity (beta = 0.35) independent of higher left ventricular ejection fraction (beta = -0.049), male sex (beta = -0.075), younger age (beta = 0.093), and smaller aortic sinus diameter (beta = 0.233) (multiple R(2) = 0.18, p < 0.001). Overall, 47.5% of patients classified as having severe AS by AVAI were reclassified to nonsevere AS when pressure recovery was taken into account. CONCLUSIONS: For accurate assessment of AS severity, pressure recovery adjustment of AVA must be routinely performed. Estimation of pressure recovery at the sinotubular junction is suggested. |
| | |
Authors:
|
Edda Bahlmann; Dana Cramariuc; Eva Gerdts; Christa Gohlke-Baerwolf; Christoph A Nienaber; Erlend Eriksen; Kristian Wachtell; John Chambers; Karl Heinz Kuck; Simon Ray |
Related Documents
:
|
18502739 - Systemic pressure does not directly affect pressure gradient and valve area estimates i... 11128779 - Physiological basis of flow dependence of gorlin formula valve area in aortic stenosis:... 18475129 - Left atrial systolic force: comparison between two methods for the noninvasive assessme... 8748769 - Clinical experience with a new pressure-adjustable shunt valve. 17605609 - Methods and reliability of echocardiographic assessment of left atrial size and mechani... 7198519 - Mechanism of early systolic closure of the aortic valve in discrete membranous subaorti... 1569779 - Superiority of the university of wisconsin solution over simple crystalloid for extende... 11848169 - Blood pressure reduction in the morning yields beneficial effects on progression of chr... 11774859 - Impact of circadian amplitude and chronotherapy: relevance to prevention and treatment ... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: JACC. Cardiovascular imaging Volume: 3 ISSN: 1876-7591 ISO Abbreviation: JACC Cardiovasc Imaging Publication Date: 2010 Jun |
Date Detail:
|
Created Date: 2010-06-14 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101467978 Medline TA: JACC Cardiovasc Imaging Country: United States |
Other Details:
|
Languages: eng Pagination: 555-62 Citation Subset: IM |
Copyright Information:
|
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany. Doc_Edda@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anticholesteremic Agents / therapeutic use Aortic Valve / drug effects, physiopathology, ultrasonography* Aortic Valve Stenosis / drug therapy, physiopathology, ultrasonography* Azetidines / therapeutic use Drug Therapy, Combination Echocardiography, Doppler* Europe Female Hemodynamics* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Image Interpretation, Computer-Assisted Male Middle Aged Predictive Value of Tests Prospective Studies Recovery of Function Reproducibility of Results Severity of Illness Index Simvastatin / therapeutic use Treatment Outcome Ventricular Function, Left |
| Chemical | |
Reg. No./Substance:
|
0/Anticholesteremic Agents; 0/Azetidines; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 163222-33-1/ezetimibe; 79902-63-9/Simvastatin |
| Comments/Corrections | |
Comment In:
|
JACC Cardiovasc Imaging. 2010 Jun;3(6):563-6
[PMID:
20541710
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Renal stem cell biology starts to take spherical shape. Commentary on: Lusis et al., Isolation of cl...
Next Document: RV electrical activation in heart failure during right, left, and biventricular pacing.