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A hybrid approach for quantification of aortic valve stenosis using cardiac magnetic resonance imaging and echocardiography:

Comparison to right heart catheterization and standard echocardiography

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Summary

We replaced Dopplerderived stroke volume in the continuity equation (method A) by either right heart catheterizationderived stroke volume (method B) or cardiovascular magnetic resonance–derived stroke volume (method C) to calculate aortic valve area in 20 consecutive patients with moderate or severe aortic stenosis. Comparison of both hybrid methods (methods B and C) by Bland–Altman analysis showed a mean difference near zero, a spread within two standard deviations and very similar limits of agreement. More importantly, all patients were classified into the same category of severity by both methods.

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References

  1. Kaden JJ, Vocke DC, Fischer CS, Grobholz R, Brueckmann M, Vahl CF, Hagl S, Haase KK, Dempfle CE, Borggrefe M (2004) Expression and activity of matrix metalloproteinase–2 in calcific aortic stenosis. Z Kardiol 93:124–130

    Article  CAS  PubMed  Google Scholar 

  2. Zoghbi WA, Farmer KL, Soto JG, Nelson JG, Quinones MA (1986) Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography. Circulation 73:452–459

    CAS  PubMed  Google Scholar 

  3. Oh JK, Taliercio CP, Holmes DR Jr, Reeder GS, Bailey KR, Seward JB, Tajik AJ (1988) Prediction of the severity of aortic stenosis by Doppler aortic valve area determination: prospective Doppler–catheterization correlation in 100 patients. J Am Coll Cardiol 11:1227–1234

    CAS  PubMed  Google Scholar 

  4. Otto CM, Pearlman AS, Comess KA, Reamer RP, Janko CL, Huntsman LL (1986) Determination of the stenotic aortic valve area in adults using Doppler echocardiography. J Am Coll Cardiol 7:509–517

    CAS  PubMed  Google Scholar 

  5. Skjaerpe T, Hegrenaes L, Hatle L (1985) Noninvasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two–dimensional echocardiography. Circulation 72:810–818

    CAS  PubMed  Google Scholar 

  6. Currie PJ, Hagler DJ, Seward JB, Reeder GS, Fyfe DA, Bove AA, Tajik AJ (1986) Instantaneous pressure gradient: a simultaneous Doppler and dual catheter correlative study. J Am Coll Cardiol 7:800–806

    CAS  PubMed  Google Scholar 

  7. Warth DC, Stewart WJ, Block PC, Weyman AE (1984) A new method to calculate aortic valve area without left heart catheterization. Circulation 70:978–983

    CAS  PubMed  Google Scholar 

  8. Haghi D, Papavassiliu T, Gabor K, Schroder M, Neff W, Kaden JJ, Muller U, Haase KK, Borggrefe M, Suselbeck T (2005) A hybrid approach for quantification of aortic valve stenosis using cardiac magnetic resonance imaging and echocardiography. Journal of Cardiovascular Magnetic Resonance 7:581–586

    Article  PubMed  Google Scholar 

  9. Pennell DJ (2002) Ventricular volume and mass by CMR. J Cardiovasc Magn Reson 4:507–513

    PubMed  Google Scholar 

  10. Horstick G, Petersen SE, Voigtlander T, Mohrs OK, Schreiber WG (2004) Cardio–MRT. The multimodal functional analysis of the future. Z Kardiol 93 (Suppl 4):IV36–47

    Article  PubMed  Google Scholar 

  11. Ahmed S, Shellock FG (2001) Magnetic resonance imaging safety: implications for cardiovascular patients. J Cardiovasc Magn Reson 3:171–182

    Article  CAS  PubMed  Google Scholar 

  12. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    CAS  PubMed  Google Scholar 

  13. Dumont Y, Arsenault M (2003) An alternative to standard continuity equation for the calculation of aortic valve area by echocardiography. J Am Soc Echocardiogr 16:1309–1315

    PubMed  Google Scholar 

  14. Smith LA, Cowell SJ, White AC, Boon NA, Newby DE, Northridge DB (2004) Contrast agent increases Doppler velocities and improves reproducibility of aortic valve area measurements in patients with aortic stenosis. J Am Soc Echocardiogr 17:247–252

    PubMed  Google Scholar 

  15. Kim KS, Maxted W, Nanda NC, Coggins K, Roychoudhry D, Espinal M, Fan P, Camino A, Sanyal R, Finch A, Kirklin J, Pacifico A (1997) Comparison of multiplane and biplane transesophageal echocardiography in the assessment of aortic stenosis. Am J Cardiol 79:436–441

    CAS  PubMed  Google Scholar 

  16. Tardif JC, Rodrigues AG, Hardy JF, Leclerc Y, Petitclerc R, Mongrain R, Mercier LA (1997) Simultaneous determination of aortic valve area by the Gorlin formula and by transesophageal echocardiography under different transvalvular flow conditions. Evidence that anatomic aortic valve area does not change with variations in flow in aortic stenosis. J Am Coll Cardiol 29:1296–1302

    CAS  PubMed  Google Scholar 

  17. Hoffmann R, Flachskampf FA, Hanrath P (1993) Planimetry of orifice area in aortic stenosis using multiplane transesophageal echocardiography. J Am Coll Cardiol 22:529–534

    CAS  PubMed  Google Scholar 

  18. Tribouilloy C, Shen WF, Peltier M, Mirode A, Rey JL, Lesbre JP (1994) Quantitation of aortic valve area in aortic stenosis with multiplane transesophageal echocardiography: comparison with monoplane transesophageal approach. Am Heart J 128:526– 532

    Article  CAS  PubMed  Google Scholar 

  19. Blumberg FC, Pfeifer M, Holmer SR, Kromer EP, Riegger GA, Elsner D (1997) Transgastric Doppler echocardiographic assessment of the severity of aortic stenosis using multiplane transesophageal echocardiography. Am J Cardiol 79:1273–1275

    CAS  PubMed  Google Scholar 

  20. Blumberg FC, Pfeifer M, Holmer SR, Kromer EP, Riegger GA, Elsner D (1998) Quantification of aortic stenosis in mechanically ventilated patients using multiplane transesophageal Doppler echocardiography. Chest 114:94–97

    CAS  PubMed  Google Scholar 

  21. Haimerl J, Freitag–Krikovic A, Rauch A, Sauer E (2005) Quantification of aortic valve area and left ventricular muscle mass in healthy subjects and patients with symptomatic aortic valve stenosis by MRI. Z Kardiol 94:173–181

    Article  CAS  PubMed  Google Scholar 

  22. John AS, Dill T, Brandt RR, Rau M, Ricken W, Bachmann G, Hamm CW (2003) Magnetic resonance to assess the aortic valve area in aortic stenosis: how does it compare to current diagnostic standards? J Am Coll Cardiol 42:519–526

    Article  PubMed  Google Scholar 

  23. Kupfahl C, Honold M, Meinhardt G, Vogelsberg H, Wagner A, Mahrholdt H, Sechtem U (2004) Evaluation of aortic stenosis by cardiovascular magnetic resonance imaging: comparison with established routine clinical techniques. Heart 90:893–901

    Article  CAS  PubMed  Google Scholar 

  24. Friedrich MG, Schulz–Menger J, Poetsch T, Pilz B, Uhlich F, Dietz R (2002) Quantification of valvular aortic stenosis by magnetic resonance imaging. Am Heart J 144:329–334

    Article  PubMed  Google Scholar 

  25. Caruthers SD, Lin SJ, Brown P, Watkins MP, Williams TA, Lehr KA, Wickline SA (2003) Practical value of cardiac magnetic resonance imaging for clinical quantification of aortic valve stenosis: comparison with echocardiography. Circulation 108:2236–2243

    Article  PubMed  Google Scholar 

  26. Gopal AS, Shen Z, Sapin PM, Keller AM, Schnellbaecher MJ, Leibowitz DW, Akinboboye OO, Rodney RA, Blood DK, King DL (1995) Assessment of cardiac function by three–dimensional echocardiography compared with conventional noninvasive methods. Circulation 92:842–853

    CAS  PubMed  Google Scholar 

  27. Sapin PM, Schroder KM, Gopal AS, Smith MD, DeMaria AN, King DL (1994) Comparison of two– and three–dimensional echocardiography with cineventriculography for measurement of left ventricular volume in patients. J Am Coll Cardiol 24:1054–1063

    CAS  PubMed  Google Scholar 

  28. Conti CR (2004) Assessment of aortic stenosis severity. Clin Cardiol 27:437– 438

    PubMed  Google Scholar 

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Correspondence to Dariusch Haghi.

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Haghi, D., Suselbeck, T., Fluechter, S. et al. A hybrid approach for quantification of aortic valve stenosis using cardiac magnetic resonance imaging and echocardiography:. Clin Res Cardiol 95, 162–167 (2006). https://doi.org/10.1007/s00392-006-0355-1

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  • DOI: https://doi.org/10.1007/s00392-006-0355-1

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