Recent findings in aortic stenosis described by M. Leye and colleagues
2009 JUL 12 - (NewsRx.com) -- "We sought to evaluate the relationship among left ventricular outflow tract diameter (LVOTd), gender, and body surface area (BSA) and to evaluate the usefulness of size-adjusted LVOTd reference values in patients with aortic stenosis (AS). AS grading is based on the echocardiographic calculation of the aortic valve area (AVA) and requires LVOTd measurements, one main potential source of error," investigators in Paris, France report. "Transesophageal echocardiography (TEE) is reputed to be more accurate than transthoracic echocardiography (TTE), but validation studies are rare. A safeguard for LVOTd measurements is thus desirable. Since January 2006, 3 subsets of patients have been prospectively and concurrently enrolled: 1) TEE group: In 120 patients with and without AS, we prospectively measured LVOTd during both TTE and TEE. 2) Validation set: In 382 patients without aortic valve or ascending aorta diseases, we evaluated the relationship among LVOTd, gender, and BSA. 3) Testing set: In 173 patients with AS, we compared the AVA obtained using measured LVOTd (AVA(MEAS)) and calculated LVOTd derived from a regression determined in the validation set (AVA(CALC)). TTE did not differ from and correlated well with TEE measurements overall (23 +/- 2 mm vs 23 +/- 2 mm, P=.26; r=0.95, P<.0001) and in patients with AS (N=43) (24 +/- 2 mm vs 24 6 3 mm, P=.15; r=0.92, P<.0001). LVOTd was linearly correlated to BSA independently of gender (LVOTd=5.7 * BSA+12.1; r=0.55, P<.0001). In the testing set, AVA(CALC) did not differ from and correlated well with AVAMEAS (1.20 +/- 0.42 cm(2) vs 1.23 +/- 0.40 cm(2); P=.08; r=0.89; P<.0001). TTE and TEE measurements of the LVOTd provided similar results. LVOTd was significantly associated to BSA and LVOTd, derived from a linear regression linked to BSA independently of gender, provided an acceptable approximation of the AVA," wrote M. Leye and colleagues. The researchers concluded: "Thus, although accurate measurement of LVOTd is a crucial part of the echocardiographic evaluation of AS severity, the present equation may be used as a safeguard when this measurement is difficult or not possible with TTE. (J Am Soc Echocardiogr 2009; 22:445-451.)." Leye and colleagues published their study in the Journal of the American Society of Echocardiography (Size-Adjusted Left Ventricular Outflow Tract Diameter Reference Values: A Safeguard for the Evaluation of the Severity of Aortic Stenosis. Journal of the American Society of Echocardiography, 2009;22(5):445-451). For additional information, contact M. Leye, Hopital Xavier Bichat, Division Cardiovascular, AP HP, Dept. of Cardiology, 46 Rue Henri Huchard, F-75018 Paris, France. The publisher of the Journal of the American Society of Echocardiography can be contacted at: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: France, Paris, Angiology, Aorta Disease, Aortic Stenosis, Aortic Valve Stenosis, Cardiography, Cardiology, Coronary Artery Disease, Echocardiography, Gender Health, Gender Medicine, Heart Disease, Women's Health. This article was prepared by Heart Disease Weekly editors from staff and other reports. Copyright 2009, Heart Disease Weekly via NewsRx.com.
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