AIMS: Two-dimensional echocardiographic (2DE) continuity-equation derived aortic valve area (AVA) in aortic stenosis (AS) relies on non-simultaneous measurement of left ventricular outflow tract (LVOT) velocity and geometric assumptions of LVOT area, which can amplify error, especially in upper septal hypertrophy (USH). We hypothesized that real-time three-dimensional echocardiography (RT3DE) can improve accuracy of AVA by directly measuring LVOT stroke volume (SV) in one window. METHODS AND RESULTS: RT3DE colour Doppler and 2DE were acquired in 68 AS patients (74 +/- 12 yrs) prospectively. SV was derived from flow obtained from a sampling curve placed orthogonal to LVOT (Tomtec Imaging). Agreement between continuity-equation derived AVA by RT3DE (AVA(3D-SV)) and 2DE (AVA(2D)) and predictors of discrepancies were analysed. Validation of LVOT SV was performed by aortic flow probe in a sheep model with balloon inflation of septum to mimic USH. There was only modest correlation between AVA(2D) and AVA(3D-SV) (r = 0.71, difference 0.11 +/- 0.23 cm(2)). The degree of USH was significantly associated with difference in AVA calculation (r = 0.4, P = 0.005). In experimentally distorted LVOT geometry in sheep, RT3DE correlated better with flow probe assessment (r = 0.96, P < 0.001) than 2DE (r = 0.71, P = 0.006). CONCLUSION: RT3DE colour Doppler-derived LVOT SV in the calculation of AVA by continuity equation is more accurate than 2D, including in situations such as USH, common in the elderly, which modify LVOT geometry.
AIMS: Two-dimensional echocardiographic (2DE) continuity-equation derived aortic valve area (AVA) in aortic stenosis (AS) relies on non-simultaneous measurement of left ventricular outflow tract (LVOT) velocity and geometric assumptions of LVOT area, which can amplify error, especially in upper septal hypertrophy (USH). We hypothesized that real-time three-dimensional echocardiography (RT3DE) can improve accuracy of AVA by directly measuring LVOT stroke volume (SV) in one window. METHODS AND RESULTS: RT3DE colour Doppler and 2DE were acquired in 68 AS patients (74 +/- 12 yrs) prospectively. SV was derived from flow obtained from a sampling curve placed orthogonal to LVOT (Tomtec Imaging). Agreement between continuity-equation derived AVA by RT3DE (AVA(3D-SV)) and 2DE (AVA(2D)) and predictors of discrepancies were analysed. Validation of LVOT SV was performed by aortic flow probe in a sheep model with balloon inflation of septum to mimic USH. There was only modest correlation between AVA(2D) and AVA(3D-SV) (r = 0.71, difference 0.11 +/- 0.23 cm(2)). The degree of USH was significantly associated with difference in AVA calculation (r = 0.4, P = 0.005). In experimentally distorted LVOT geometry in sheep, RT3DE correlated better with flow probe assessment (r = 0.96, P < 0.001) than 2DE (r = 0.71, P = 0.006). CONCLUSION: RT3DE colour Doppler-derived LVOT SV in the calculation of AVA by continuity equation is more accurate than 2D, including in situations such as USH, common in the elderly, which modify LVOT geometry.
Authors: Miguel A Quiñones; Catherine M Otto; Marcus Stoddard; Alan Waggoner; William A Zoghbi Journal: J Am Soc Echocardiogr Date: 2002-02 Impact factor: 5.251
Authors: James Pemberton; Shuping Ge; Karl Thiele; Michael Jerosch-Herold; David J Sahn Journal: J Am Soc Echocardiogr Date: 2006-11 Impact factor: 5.251
Authors: Joseph A Lodato; Lynn Weinert; Rolf Baumann; Patrick Coon; Allen Anderson; Antony Kim; Savitri Fedson; Lissa Sugeng; Roberto M Lang Journal: J Am Soc Echocardiogr Date: 2007-02 Impact factor: 5.251
Authors: Seisyou Kou; Luis Caballero; Raluca Dulgheru; Damien Voilliot; Carla De Sousa; George Kacharava; George D Athanassopoulos; Daniele Barone; Monica Baroni; Nuno Cardim; Jose Juan Gomez De Diego; Andreas Hagendorff; Christine Henri; Krasimira Hristova; Teresa Lopez; Julien Magne; Gonzalo De La Morena; Bogdan A Popescu; Martin Penicka; Tolga Ozyigit; Jose David Rodrigo Carbonero; Alessandro Salustri; Nico Van De Veire; Ralph Stephan Von Bardeleben; Dragos Vinereanu; Jens-Uwe Voigt; Jose Luis Zamorano; Erwan Donal; Roberto M Lang; Luigi P Badano; Patrizio Lancellotti Journal: Eur Heart J Cardiovasc Imaging Date: 2014-01-21 Impact factor: 6.875
Authors: Paul Schoenhagen; Alexander Hill; Tim Kelley; Zoran Popovic; Sandra S Halliburton Journal: J Cardiovasc Transl Res Date: 2011-04-12 Impact factor: 4.132
Authors: Mayooran Namasivayam; Wei He; Timothy W Churchill; Romain Capoulade; Shiying Liu; Hang Lee; Jacqueline S Danik; Michael H Picard; Philippe Pibarot; Robert A Levine; Judy Hung Journal: J Am Coll Cardiol Date: 2020-04-21 Impact factor: 24.094
Authors: Mackram F Eleid; Paul Sorajja; Hector I Michelena; Joseph F Malouf; Christopher G Scott; Patricia A Pellikka Journal: Circulation Date: 2013-09-18 Impact factor: 29.690