Reliability of Two-dimensional Echocardiography in Assessing the Severity of Valvular Aortic Stenosis

Godley, Robert W.; Green, Debbie; Dillon, James C.; Rogers, Edwin W.; Feigenbaum, Harvey; Weyman, Arthur E.

doi:10.1378/chest.79.6.657

Cited by 46 publications

(7 citation statements)

References 8 publications

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“…Although the study was not designed specifically to assess the ability of twodimensional scanning and colour-flow Doppler to assess clinically important lesions adequately, it was reassuring that there were no instances where moderate or severe valve lesions were incorrectly diagnosed or missed. Discrimination of clinically important valvular disease such as severe aortic stenosis has also been demonstrated by limited TTE in other studies [33][34][35]. Transthoracic echocardiography is a commonly performed pre-operative investigation, but there is a lack of agreement in the literature of the exact indications for echocardiography, and its influence on management decisions has not been previously reported.…”

Section: Discussionmentioning

confidence: 95%

The impact of focused transthoracic echocardiography in the pre‐operative clinic

et al. 2012

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SummaryPatients with suspected or symptomatic cardiac disease, associated with increased peri-operative risk, are often seen by anaesthetists in the pre-assessment clinic. The use of transthoracic echocardiography in this setting has not been reported. This prospective observational study investigated the effect of echocardiography on the anaesthetic management plan in 100 patients who were older than 65 years or had suspected cardiac disease. Echocardiography was performed by an anaesthetist, and was validated by a cardiologist. Overall, the anaesthetic plan was changed in 54 patients. Haemodynamically significant cardiac disease was revealed in 31 patients, resulting in a step-up of treatment in 20 patients, including: cardiology referral (four patients); altered surgical (two) and anaesthetic (four) technique; use of invasive monitoring (13); planned use of vasopressor infusion (10); and postoperative high dependency care (five). Reassuring negative findings in 69 patients led to a step-down in treatment in 34 patients: altered anaesthetic technique (six); procedure not cancelled (10); cardiology referral not made (10); use of invasive monitoring not required (seven); and high dependency care not booked (11). We conclude that focused transthoracic echocardiography in the preoperative clinic is feasible and frequently alters management in patients with suspected cardiac disease.

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Section: Discussionmentioning

confidence: 95%

The impact of focused transthoracic echocardiography in the pre‐operative clinic

et al. 2012

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“…Indeed, when only the 11 patients aged <50 years were included in the analysis the correlation coefficient was 0.90. The continuous Doppler method, therefore, seems to be superior to other noninvasive techniques8 9-including M-mode echocardiography,'0 cross sectional echocardiography,7 11 and the pulsed wave Doppler'2 method-in assessing the severity of aortic stenosis.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of systolic murmurs by Doppler ultrasonography.

Hoffmann¹,

Burckhardt²

1983

Heart

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SUMMARY Non-invasive continuous and pulsed wave Doppler ultrasonography was performed in 102 consecutive patients with clinically ill defined systolic murmurs to differentiate between flow murmurs, mitral regurgitation, aortic stenosis, and ventricular septal defect, as well as to assess the severity of aortic stenosis.Diagnoses with the Doppler method were based on velocity, direction, and duration of flow signals and were subsequently verified by cardiac catheterisation in all patients. Multiple evaluations were made in 31 patients. Sensitivity and specificity were 0-87 and 0 77 in mitral regurgitation, 0.9 and 1.0 in aortic stenosis, and 1.0 and 1.0 in ventricular septal defect. In 67 patients the estimation of severity of aortic stenosis using the Doppler technique to calculate aortic pressure gradients from maximum flow velocity was significantly correlated with that determined at catheterisation.It is concluded that Doppler ultrasonography is a highly useful technique for the non-invasive evaluation of clinically ill defined systolic murmurs.

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“…Unfortunately, similar accuracy in detennining the severity of aortic stenosis has not been demonstrated, especially in older patients with calcific aortic leaflets Dragulescu et al, 1980;Godley et al, 1981;Weyman et al, 1975Weyman et al, , 1977. This study correlated the severity of aortic stenosis using the aortic valve area obtained during cardiac catheterization with various parameters obtained during 2-D echocardiography.…”

Section: Introductionmentioning

confidence: 88%

Correlation between calcific aortic stenosis diagnosed by two‐dimensional echocardiography and cardiac catheterization

Nair

Aronow

Sketch

et al. 1984

Clinical Cardiology

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Summary: This retrospective study correlates the severity of calcific aortic stenosis detennined by twodimensional (2-D) echocardiography with the aortic valve area determined by catheterization in 57 patients. Aortic valve leaflet calcification was diagnosed by cineangiography in 50 (88 %) of 57 patients and by 2-D echo in 57 (100%) of 57 patients (p<0.025). An agreement between severity of aortic stenosis by catheterization and 2-D echo occurred in 22 (39%) of 57 patients. Chisquare and logistic regression analyses showed no correlation between the severity of aortic stenosis and the 2-D echo variables: left ventricular wall thickness, left ventricular diastolic dimension, left ventricular systolic dimension, aortic root diameter, and left atrial dimension. We conclude that 2-D echo detects aortic leaflet calcification better than cineangiography. However, the severity of aortic stenosis determined by 2-D echo correlates poorly with the severity of aortic stenosis determined by cardiac catheterization.

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Reliability of Two-dimensional Echocardiography in Assessing the Severity of Valvular Aortic Stenosis

Cited by 46 publications

References 8 publications

The impact of focused transthoracic echocardiography in the pre‐operative clinic

The impact of focused transthoracic echocardiography in the pre‐operative clinic

Evaluation of systolic murmurs by Doppler ultrasonography.

Correlation between calcific aortic stenosis diagnosed by two‐dimensional echocardiography and cardiac catheterization

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