Document Detail

Inconsistencies of echocardiographic criteria for the grading of aortic valve stenosis.
MedLine Citation:
PMID:  18156619     Owner:  NLM     Status:  MEDLINE    
AIM: The present study tests the consistency of echocardiographic criteria for the grading of aortic valve stenosis. METHODS AND RESULTS: Current guidelines/recommendations define severe stenosis as an aortic valve area (AVA) <1 cm2 (or <0.6 cm2 adjusted for body surface area), mean pressure gradient (DeltaPm) >40 mmHg, or peak flow velocity (Vmax) >4 m/s. We tested the consistency of the three criteria for the grading of aortic valve stenosis in 3483 echocardiography studies performed in 2427 patients with normal left ventricular (LV) systolic function and a calculated AVA of < or =2 cm2. We calculated curve fits for the relationship between AVA and DeltaPm using the Gorlin equation and between AVA and Vmax based on the continuity equation for our study population. An AVA of 1.0 cm2 correlated to a DeltaPm of 21 mmHg and a Vmax of 3.3 m/s. Conversely, a DeltaPm of 40 mmHg corresponds to an AVA of 0.75 cm2 and a Vmax of 4.0 m/s to an AVA of 0.82 cm2. Consequently, severe stenosis was diagnosed in 69% of patients based on AVA, 45% on Vmax, and 40% on DeltaPm. Stroke volume was lower in inconsistently graded patients (65 +/- 11 mL vs. consistently graded: 70 +/- 14 mL, P < 0.001). CONCLUSION: The criteria for the grading of aortic stenosis are inconsistent in patients with normal systolic LV function. On the basis of AVA, a higher proportion of patients is classified as having severe aortic valve stenosis compared with mean pressure gradient and peak flow velocity. Discrepant grading in these patients may be partly due to reduced stroke volume.
Jan Minners; Martin Allgeier; Christa Gohlke-Baerwolf; Rolf-Peter Kienzle; Franz-Josef Neumann; Nikolaus Jander
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Publication Detail:
Type:  Journal Article     Date:  2007-12-22
Journal Detail:
Title:  European heart journal     Volume:  29     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-15     Completed Date:  2008-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1043-8     Citation Subset:  IM    
Department of Cardiology, Herz-Zentrum Bad Krozingen, Suedring 15, 79189 Bad Krozingen, Germany.
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MeSH Terms
Acute Disease
Aortic Valve Stenosis / physiopathology,  ultrasonography*
Blood Flow Velocity / physiology
Blood Pressure
Echocardiography / methods,  standards*,  statistics & numerical data
Practice Guidelines as Topic
Stroke Volume / physiology
Systole / physiology
Ventricular Function, Left / physiology*
Comment In:
Eur Heart J. 2008 Apr;29(8):966-8   [PMID:  18343797 ]

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

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