Document Detail

Ventricular stroke work loss: validation of a method of quantifying the severity of aortic stenosis and derivation of an orifice formula.
MedLine Citation:
PMID:  2254546     Owner:  NLM     Status:  MEDLINE    
Because aortic stenosis results in the loss of left ventricular stroke work (due to resistance to flow through the valve and turbulence in the aorta), the percentage of stroke work that is lost may reflect the severity of stenosis. This index can be calculated from pressure data alone. The relation between percent stroke work loss and anatomic aortic valve orifice area (measured by planimetry from videotape) was investigated in a pulsatile flow model. Thirteen valves were studied (nine human aortic valves obtained at necropsy and four bioprosthetic valves) at stroke volumes of 40 to 100 ml, giving 57 data points. Valve area ranged from 0.3 to 2.8 cm2 and mean systolic pressure gradient from 3 to 84 mm Hg. Percent stroke work loss, calculated as mean systolic pressure gradient divided by mean ventricular systolic pressure x 100%, ranged from 7 to 68%. It was closely related to anatomic orifice area with an inverse exponential relation and was not significantly related to flow (r = -0.15). An orifice formula was derived that predicted anatomic orifice area with a 95% confidence interval of +/- 0.5 cm2 (orifice area [cm2] = 4.82 [2.39 x log percent stroke work loss], r = -0.94, SEE = 0.029). These results support the clinical use of percent stroke work loss as an easily obtained index of the severity of aortic stenosis.
D C Sprigings; J B Chambers; T Cochrane; J Allen; G Jackson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  16     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-24     Completed Date:  1991-01-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1608-14     Citation Subset:  AIM; IM    
Cardiac Department, Kings College Hospital, London, England.
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MeSH Terms
Aortic Valve / pathology
Aortic Valve Stenosis / diagnosis*,  physiopathology
Heart Valve Prosthesis
Models, Cardiovascular
Pulsatile Flow / physiology
Regression Analysis
Stroke Volume / physiology*
Comment In:
J Am Coll Cardiol. 1990 Dec;16(7):1615-6   [PMID:  2254547 ]

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

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