OBJECTIVES: The purpose of this study was to investigate whether the orifice area in aortic stenosis can be determined accurately and reliably by multiplane transesophageal echocardiography. BACKGROUND: Monoplane transesophageal echocardiography has been used for planimetry of aortic valve orifice areas; however, obtaining a precise short-axis view is sometimes impossible. METHODS: In 41 consecutive patients with known valvular calcific aortic stenosis (20 men, mean age 64 +/- 9 years), aortic valve orifice area was measured by planimetry using a multiplane transesophageal echocardiographic probe that allows full rotation of the cross-sectional plane. Results were compared with invasive measurements obtained by the Gorlin formula and areas determined noninvasively by transthoracic echocardiography using the continuity equation. RESULTS: Multiplane transducer technology enabled the rotation of the cross-sectional plane from an exactly aligned long-axis view of the stenosed valve to a precise short-axis view without moving the tip of the echocardiographic probe, thus achieving an orifice cross section at a level predetermined in the long-axis view. Planimetry was feasible in 38 patients (93%). In three patients with pinhole stenosis (area determined by the Gorlin formula < 0.4 cm2), the valve area could not be exactly delineated. Correlation between areas derived by transesophageal echocardiographic planimetry (0.56 +/- 0.31 cm2) and by the Gorlin formula (0.58 +/- 0.31 cm2) was excellent (r = 0.95; standard deviation of regression [SDR] = 0.054; Y = 0.92X + 0.085, where Y = Gorlin area and X = planimetry area). Correlation between Gorlin- and continuity equation-derived areas (0.65 +/- 0.46 cm2) was r = 0.79; for continuity equation- and transesophageal planimetry-derived areas it was r = 0.83. Severe aortic stenosis (valve area < or = 0.75 cm2) was predicted with high sensitivity (96%) and specificity (88%). CONCLUSIONS: Multiplane transesophageal echocardiography is a practical and accurate clinical tool for the assessment of the severity of aortic stenosis.
OBJECTIVES: The purpose of this study was to investigate whether the orifice area in aortic stenosis can be determined accurately and reliably by multiplane transesophageal echocardiography. BACKGROUND: Monoplane transesophageal echocardiography has been used for planimetry of aortic valve orifice areas; however, obtaining a precise short-axis view is sometimes impossible. METHODS: In 41 consecutive patients with known valvular calcific aortic stenosis (20 men, mean age 64 +/- 9 years), aortic valve orifice area was measured by planimetry using a multiplane transesophageal echocardiographic probe that allows full rotation of the cross-sectional plane. Results were compared with invasive measurements obtained by the Gorlin formula and areas determined noninvasively by transthoracic echocardiography using the continuity equation. RESULTS: Multiplane transducer technology enabled the rotation of the cross-sectional plane from an exactly aligned long-axis view of the stenosed valve to a precise short-axis view without moving the tip of the echocardiographic probe, thus achieving an orifice cross section at a level predetermined in the long-axis view. Planimetry was feasible in 38 patients (93%). In three patients with pinhole stenosis (area determined by the Gorlin formula < 0.4 cm2), the valve area could not be exactly delineated. Correlation between areas derived by transesophageal echocardiographic planimetry (0.56 +/- 0.31 cm2) and by the Gorlin formula (0.58 +/- 0.31 cm2) was excellent (r = 0.95; standard deviation of regression [SDR] = 0.054; Y = 0.92X + 0.085, where Y = Gorlin area and X = planimetry area). Correlation between Gorlin- and continuity equation-derived areas (0.65 +/- 0.46 cm2) was r = 0.79; for continuity equation- and transesophageal planimetry-derived areas it was r = 0.83. Severe aortic stenosis (valve area < or = 0.75 cm2) was predicted with high sensitivity (96%) and specificity (88%). CONCLUSIONS: Multiplane transesophageal echocardiography is a practical and accurate clinical tool for the assessment of the severity of aortic stenosis.
Authors: Hector I Michelena; Martin D Abel; Rakesh M Suri; William K Freeman; Roger L Click; Thoralf M Sundt; Hartzell V Schaff; Maurice Enriquez-Sarano Journal: Mayo Clin Proc Date: 2010-07 Impact factor: 7.616
Authors: D Haghi; T Suselbeck; S Fluechter; G Kalmar; M Schroder; J J Kaden; T Poerner; M Borggrefe; T Papavassiliu Journal: Clin Res Cardiol Date: 2006-02-13 Impact factor: 5.460