Document Detail


Relationship between Cutoff Values of Peak Aortic Valve Velocity and Those of Other Doppler Echocardiographic Parameters of Severity in Patients with Aortic Stenosis and Normal Flow.
MedLine Citation:
PMID:  22862297     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have reported inconsistencies between echocardiographic parameters of severity in aortic valve stenosis (AS). Peak aortic valve velocity (V(max) ) strongly predicts outcome in AS patients. This study was therefore designed to identify the cutoff values of echocardiographic parameters of severity corresponding to a V(max)  ≥ 3 m/sec, ≥4 m/sec, 5 m/sec, or 5.50 m/sec in a large cohort of patients with normal flow (NF) AS. Methods and Results: We retrospectively reviewed the echocardiograms of 528 consecutive patients with normal flow (NF) AS, left ventricular (LV) ejection fraction ≥0.50, and NF (stroke volume index > 35 mL/m²). The values of mean pressure gradient (MPG), aortic valve area (AVA), and indexed aortic valve area (IAVA) corresponding to V(max)  ≥ 3 m/sec obtained from receiver operating characteristic (ROC) curves analysis were 22 mmHg, 1.15 cm(2) , and 0.60 cm(2) /m(2) , respectively. While a cutoff of V(max)  ≥ 4 m/sec to define severe AS was consistent with a value of 39 mmHg for MPG, corresponding values for AVA and IAVA of 0.90 cm² and 0.48 cm²/m², respectively, were substantially different from those recommended in current guidelines. MPG ≥60 and 65 mmHg, AVA ≤0.76 and ≤0.68 cm², and IAVA ≤0.41 and ≤0.35 cm(2) /m(2) were related to a V(max)  ≥5 and ≥5.5 m/sec (very severe AS), respectively. CONCLUSIONS: Guidelines recommended cutoff values for AVA and IAVA are not consistent with those of V(max) and MPG. The results of this study may serve as safeguard in case of apparent inconsistencies between echocardiographic parameters of severity in NF AS.
Authors:
Anne-Laure Castel; Sylvestre Maréchaux; Jamal Laaouaj; Dan Rusinaru; Franck Levy; Christophe Tribouilloy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-3
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  -     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012, Wiley Periodicals, Inc.
Affiliation:
Cardiology Department, Inserm, ERI 12, Amiens University Hospital, Amiens, France.
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