Three-D measurements of LVOT: impact on quantification of aortic stenosis (AS). (25th November 2020)

• Record Type: Journal Article
• Authors: Anderson, N; Thiru, S; Chenzbraun, A
• Is Part Of: European heart journal. Volume 41:(2020)Supplement 2
• Publication Date: 2020-11-25
• Subjects: Valvular Heart Disease - Diagnostic Methods; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/ehjci/ehaa946.1913
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Discrepancies between aortic valve area (AVA) and gradients are recognized in patients with AS and normal LVEF and can impact on surgical referral decisions. Purpose: Pilot study to determine whether using 3D rather than 2D LVOT dimensions leads to fewer discrepancies and less patients diagnosed with severe AS by continuity equation. Methods: AS was quantified as per BSE guidelines in 55 consecutive patients (M: 32, age: 73±10) with LVEF>50% and at least moderate AS by AVA. LVOT was imaged with 3D zoom and its two orthogonal diameters were used to calculate the LVOT area for the continuity equation. Results: Severe AS was diagnosed by AVA in 24/55 (44%) patients (Table 1). By 3D measurements the LVOT eccentricity index (D1/D2) was 0.8±0.1 and the LVOT area and SVi were larger than the ones calculated by 2D measurements:3.74±0.7 cm 2 vs. 3.29±0.5 cm 2 and 51.4±13 ml/BSA, vs. 45.3±9 ml/BSA, respectively, p<0.05. 3D measurements reduced the number of severe AS cases from 24 to 18 (AVA) and from 33 to 24 (AVAi) (25% and 27% respectively, p<0.05). AS severity agreement for all parameters slightly improved from 34/55 (62%) to 37/55/ (67%), p: ns Conclusions: 1) In this pilot study, the use of 3D-derived LVOT measurements reduced by 25% the frequency of severe AS diagnosis. 2) If these results are confirmed in larger studies, use of 3D LVOT measurements may become standard of practice. Funding Acknowledgement: Type of funding source: None