Page 13 - Journal of Structural Heart Disease Volume 5, Issue 3

Original Scientific Article
Journal of Structural Heart Disease, June 2019, Volume 5, Issue 3:52-61
DOI: https://doi.org/10.12945/j.jshd.2019.025.18
Received: July 03, 2018 Accepted: July 27, 2018 Published online: June 2019
Difference in Aortic Valve Area Measured With Cardiac CT and Transthoracic Echocardiography
Sung Min Ko, MD1, Jose F. Condado, MD2, Vasilis Babaliaros, MD2, Stamatios Lerakis, MD2, Yi-An Ko, PhD3, Arthur E. Stillman, MD4*
1 Department of Radiology, Konkuk University Medical Center, Seoul, Korea
2 Department of Cardiology, Emory University Hospital, Atlanta, Georgia, United States
3 Department of Biostatistics and Bioinformatics, Emory University Hospital, Atlanta, Georgia, United States
4 Department of Radiology, Division of Cardiothoracic Imaging, Emory University Hospital, Atlanta, Georgia, United States
Abstract
Background: There is difference in aortic valve area (AVA) measurement between cardiac computed to- mography (CCT) and transthoracic echocardiography (TTE).
Objectives: To evaluate factors affecting the measure- ment of AVA obtained with CCT and TTE in patients with severe aortic stenosis.
Method: One hundred twenty-seven consecutive pa- tients (median age, 81 years, 57% women) that un- derwent TTE, CCT, and transcatheter aortic valve re- placement were included. AVA was deduced from the continuity equation on TTE (AVATTE) and manual planimetry on CCT (AVACCT). Factors that related to difference between AVACCT and AVATTE were evaluat- ed by linear regression analysis.
Result: AVACCT (0.92±0.36 cm2, p<0.001) was signifi- cantly greater than AVATTE (0.69±0.16 cm2). There was a weak positive correlation between AVAs measured with CCT and TTE (r=0.25, p=0.004). There was signifi- cant difference between CCT (5.0±0.92 cm2, p<0.001) and TTE (3.52±0.77 cm2) measurements of left ven- tricular outflow tract (LVOT) area. The LVOT area was generally elliptical (>10% difference between LVOT di- ameters in 95.3% patients). Multiple linear regression
showed that difference between AVACCT and AVATTE was significantly associated with log-transformed aortic valve calcium score (estimate -0.267, p<0.001), LVOT area difference between CCT and TTE (estimate -0.082, p=0.006), and age (estimate -0.006, p=0.01). In case of LV ejection fraction <50%, aortic valve calci- um score ≥1,651, LVOT eccentricity ≥0.78, presence of atrial fibrillation, absence of significant calcification of aortic valve, or mean transaortic pressure gradient ≤40 mmHg, there was no significant correlation between AVACCT and AVATTE.
Conclusion: Age, Agatston aortic valve score, and LVOT area difference between CCT and TTE might affect dif- ference between AVACCT and AVATTE in patients with severe aortic stenosis.
Copyright © 2019 Science International Corp.
Key Words
Computed tomography • Echocardiography • Aortic stenosis • Aortic valve area • Planimetry
Introduction
Aortic stenosis (AS) is one of the most common val- vular heart disease (VHD) worldwide. Its prevalence is increased with advancing age. In addition, AS is
* Corresponding Author:
Arthur E. Stillman, MD
Department of Radiology, Division of Cardiothoracic Imaging Emory University Hospital
1364 Clifton Road Northeast, , , Atlanta, GA 30322,
Tel. +404 712 7964; Fax: +404 712 7777; E-Mail: aestill@emory.edu
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
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