Aortic valve type and calcification as assessed by transthoracic and transoesophageal echocardiography. (29th May 2014)

• Record Type: Journal Article
• Authors: Yousry, Mohamed; Rickenlund, Anette; Petrini, Johan; Jenner, Jonas; Liska, Jan; Eriksson, Per; Franco‐Cereceda, Anders; Eriksson, Maria J.; Caidahl, Kenneth
• Is Part Of: Clinical physiology and functional imaging. Volume 35:Number 4(2015:Jul.)
• Page Start: 306
• Page End: 313
• Publication Date: 2014-05-29
• Subjects: Physiology, Pathological -- Periodicals; Diagnostic imaging -- Periodicals; 612
• DOI: 10.1111/cpf.12166
• Languages: English
• ISSNs: 1475-0961

Abstract

<abstract abstract-type="main" id="cpf12166-abs-0001"> <title>Summary</title> <sec id="cpf12166-sec-0001" sec-type="section"> <title>Introduction</title> <p>Aortic valve calcification (AVC) may predict poor outcome. Bicuspid aortic valve (BAV) leads to several haemodynamic changes accelerating the progress of aortic valve (AV) disease.</p> </sec> <sec id="cpf12166-sec-0002" sec-type="section"> <title>Aims</title> <p>To compare the diagnostic accuracy of transoesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) in the assessment of aortic valve phenotype and degree of AVC, with intra‐operative evaluation as a reference.</p> </sec> <sec id="cpf12166-sec-0003" sec-type="section"> <title>Methods</title> <p>We examined 169 patients (median age 65 years, 51 women) without significant coronary artery disease undergoing AV and/or aortic root surgery. TTE was performed within a week prior to surgery and TEE at the time of surgery.</p> </sec> <sec id="cpf12166-sec-0004" sec-type="section"> <title>Results</title> <p>Compared with surgical AVC assessment, visual evaluation using a 5‐grade scoring system and real‐time images showed a higher correlation (TTE <italic>r </italic>=<italic> </italic>0·83 and TEE <italic>r </italic>=<italic> </italic>0·82) than visual (TTE <italic>r </italic>=<italic> </italic>0·64 and TEE 0·63) or grey scale mean (GSMn) (TTE <italic>r </italic>=<italic> </italic>0·63 and TEE <italic>r </italic>=<italic> </italic>0·52) assessment of end‐diastolic still frames. AVC assessment using real‐time images showed high intraclass correlation coefficients (TTE 0·94 and TEE 0·93). With regard to BAV, TEE was superior to TTE with a higher interobserver agreement, sensitivity and specificity (0·86, 92% and 94% versus 0·57, 77% and 82%, respectively).</p> </sec> <sec id="cpf12166-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Semi‐quantitative AVC assessment of real‐time cine loops from both TEE and TTE correlated well with intra‐operative evaluation of AVC. Applying a predefined scoring system for AVC evaluation assures a high interobserver correlation. TEE was superior to TTE for evaluation of valve phenotype and should be considered when a diagnosis of BAV is clinically important.</p> </sec> </abstract>