Integration of 3D imaging data in the assessment of aortic stenosis impact on classification of disease severity

Bridget O'Brien, Paul Schoenhagen, Samir R. Kapadia, Lars G. Svensson, Leonardo Rodriguez, Brian P. Griffin, E. Murat Tuzcu, Milind Y. Desai

Research output: Contribution to journalArticlepeer-review

Abstract

Background-In patients with aortic stenosis (AS), precise assessment of severity is critical for treatment decisions. Estimation of aortic valve area (AVA) with transthoracic echocardiographic (TTE)-continuity equation (CE) assumes a circular left ventricular outflow tract (LVOT). We evaluated incremental utility of 3D multidetector computed tomography (MDCT) over TTE assessment of AS severity. Methods and Results-We included 51 patients (age, 81±8 years; 61% men; mean gradient, 42±12 mm Hg) with calcific AS who underwent evaluation for treatment options. TTE parameters included systolic LVOT diameter (D) and continuous and pulsed wave (CW and PW) velocity-time integrals (VTI) through the LVOT and mean transaortic gradient. MDCT parameters included systolic LVOT area, ratio of maximal to minimal LVOT diameter (eccentricity index), and aortic planimetry (AVAp). TTE-CE AVA [(D2×0.786×VTIpw)/VTIcw] and dimensionless index (DI) [VTIpw/VTIcw] were calculated. Corrected AVA was calculated by substituting MDCT LVOT area into CE. The majority (96%) of patients had eccentric LVOT. LVOT area, measured on MDCT, was higher than on TTE (3.84±0.8 cm2 versus 3.03±0.5 cm2, P2, 0.82±0.3 cm 2, and 0.86±0.3 cm2, P2), which increased to 92% using corrected CE.

Original languageEnglish (US)
Pages (from-to)566-573
Number of pages8
JournalCirculation: Cardiovascular Imaging
Volume4
Issue number5
DOIs
StatePublished - Sep 2011
Externally publishedYes

Keywords

  • Aortic stenosis
  • Aortic valve area
  • Multidetector computed tomography
  • Transthoracic echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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