Original Scientific Articles
Journal of Structural Heart Disease, June 2019, Volume 5, Issue 3:52-61
Difference in Aortic Valve Area Measured With Cardiac CT and Transthoracic Echocardiography
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
Background: There is a difference in aortic valve area (AVA) measurement between cardiac computed tomography (CCT) and transthoracic echocardiography (TTE).
Objectives: To evaluate factors affecting the measurement of AVA obtained with CCT and TTE in patients with severe aortic stenosis.
Method: One hundred twenty-seven consecutive patients (median age, 81 years, 57% women) that underwent TTE, CCT, and transcatheter aortic valve replacement 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 evaluated by linear regression analysis.
Result: AVACCT (0.92±0.36 cm2, p<0.001) was significantly 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 a significant difference between CCT (5.0±0.92 cm2, p<0.001) and TTE (3.52±0.77 cm2) measurements of left ventricular outflow tract (LVOT) area. The LVOT area was generally elliptical (>10% difference between LVOT diameters in 95.3% patients). Multiple linear regression Introduction Aortic stenosis (AS) is one of the most common valvular heart disease (VHD) worldwide. Its prevalence is increased with advancing age. In addition, AS is 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 calcium 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 the difference between AVACCT and AVATTE in patients with severe aortic stenosis.
Cite this article as: Ko SM, Condado JF, Babaliaros V, Lerakis S, Ko Y, Stillman AE. Difference in Aortic Valve Area Measured With Cardiac CT and Transthoracic Echocardiography. Structural Heart Disease 2019;5(3):52-61. DOI: 10.12945/j.jshd.2019.025.18
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