Application of a Novel Two-Dimensional Echocardiographic Calcium Quantification Method to Assess All Severities of Aortic Stenosis.


Journal

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388

Informations de publication

Date de publication:
01 2023
Historique:
received: 06 10 2022
revised: 27 10 2022
accepted: 28 10 2022
pubmed: 9 11 2022
medline: 10 1 2023
entrez: 8 11 2022
Statut: ppublish

Résumé

Aortic valve (AV) calcification (AVC) is a strong predictor of aortic stenosis (AS) severity. The two-dimensional AVC (2D-AVC) ratio, a gain-independent ratio composed of the average pixel density of the AV and the aortic annulus, has previously shown strong correlations with two-dimensional (2D) echocardiographic hemodynamic parameters for severe AS and AVC by cardiac computed tomography. We hypothesize that the 2D-AVC ratio correlates with hemodynamic parameters in all severities of AS. A total of 285 patients with a normal AV (n = 49), aortic sclerosis (n = 75), or mild (n = 38), moderate (n = 72), or severe (n = 51) AS undergoing 2D echocardiography were retrospectively evaluated, and the 2D-AVC ratios were correlated to mean AV gradient, peak AV velocity, AV area, and dimensionless index. The 2D-AVC ratios of various AS severities were compared against each other via area under the curve (AUC) analysis. The 2D-AVC ratio is strongly correlated with mean AV gradient (r = 0.79, P < .0001) and peak AV velocity (r = 0.78, P < .0001). There was moderate correlation with the AV area (r = -0.58, P < .0001) and dimensionless index (r = -0.67, P < .0001) across all AS severities. The 2D-AVC ratio also distinguished nonmoderate AS (mild AS + normal AV) from moderate or greater (moderate + severe) AS (AUC = 0.93) and moderate versus severe AS (AUC = 0.88). The 2D-AVC ratio exhibits moderate to strong correlation with 2D echocardiographic hemodynamic parameters across all severities of AS.

Sections du résumé

BACKGROUND
Aortic valve (AV) calcification (AVC) is a strong predictor of aortic stenosis (AS) severity. The two-dimensional AVC (2D-AVC) ratio, a gain-independent ratio composed of the average pixel density of the AV and the aortic annulus, has previously shown strong correlations with two-dimensional (2D) echocardiographic hemodynamic parameters for severe AS and AVC by cardiac computed tomography. We hypothesize that the 2D-AVC ratio correlates with hemodynamic parameters in all severities of AS.
METHODS
A total of 285 patients with a normal AV (n = 49), aortic sclerosis (n = 75), or mild (n = 38), moderate (n = 72), or severe (n = 51) AS undergoing 2D echocardiography were retrospectively evaluated, and the 2D-AVC ratios were correlated to mean AV gradient, peak AV velocity, AV area, and dimensionless index. The 2D-AVC ratios of various AS severities were compared against each other via area under the curve (AUC) analysis.
RESULTS
The 2D-AVC ratio is strongly correlated with mean AV gradient (r = 0.79, P < .0001) and peak AV velocity (r = 0.78, P < .0001). There was moderate correlation with the AV area (r = -0.58, P < .0001) and dimensionless index (r = -0.67, P < .0001) across all AS severities. The 2D-AVC ratio also distinguished nonmoderate AS (mild AS + normal AV) from moderate or greater (moderate + severe) AS (AUC = 0.93) and moderate versus severe AS (AUC = 0.88).
CONCLUSION
The 2D-AVC ratio exhibits moderate to strong correlation with 2D echocardiographic hemodynamic parameters across all severities of AS.

Identifiants

pubmed: 36347388
pii: S0894-7317(22)00580-6
doi: 10.1016/j.echo.2022.10.023
pii:
doi:

Substances chimiques

Calcium SY7Q814VUP

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

69-76

Informations de copyright

Copyright © 2022 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Auteurs

Kevin Desai (K)

Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.

Brody Slostad (B)

Department of Cardiology, University of Illinois at Chicago, Chicago, Illinois.

Aamir Twing (A)

Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.

Hema Krishna (H)

Department of Cardiology, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown Veteran Affairs Medical Center, Chicago, Illinois.

Leon Frazin (L)

Department of Cardiology, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown Veteran Affairs Medical Center, Chicago, Illinois.

Mayank Kansal (M)

Department of Cardiology, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown Veteran Affairs Medical Center, Chicago, Illinois. Electronic address: mmkansal@uic.edu.

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Classifications MeSH