Miramontes-Espino MV, Medina-Torres ÓS, Hernández-Perales HJ, Carrillo-Torres MÁ, Hernández-González MA, Ceja-Camarillo LA

Language: English
References: 17
Page: 15-21
PDF size: 228.48 Kb.

ABSTRACT

Introduction: Aortic stenosis (AS) is a progressive disease whose final stage results in an inadequate cardiac output and death from cardiovascular causes. Its severity can be assessed by non-invasive methods such as echocardiography; however, discrepancies have been observed between severity estimated by the continuity equation and transvalvular gradients in up to a third of patients with preserved LVEF when compared with hemodynamic parameters obtained by cardiac catheterization. Recent studies have evaluated the usefulness of ejection dynamics, such as acceleration time (AT) and acceleration time/ejection time (AT/ET) ratio, as diagnostic and prognostic parameters. Objective: To assess whether AT and AT/ET ratio measured in the continuous Doppler curve of aortic flow have a direct relationship with severity of AS. Material and methods: Cross-sectional, analytical and predictive study. Patients with AS (aortic peak velocity ›2m/s) were included. General characteristics, clinical presentation and echocardiographic parameters were analyzed in different stages of AS. A ROC curve was plotted to determine the best cutoff value of AT, ET and AT/ET ratio to identify severe AS. Results: 75 patients were included (mean age 64.7±16.7 years, 48% women); of whom 8 had mild AS (10.7%), 16 had moderate AS (21.3%) and 51 had severe AS (68%). A cutoff value of 104.5ms for AT had a sensitivity of 92.2% and a specificity of 83.3% for severe AS; a cut-off value of 323.5ms for ET had a sensitivity of 80.4% and a specificity of 70.8%, and a cut-off value of 0.345 for AT/ET ratio had a sensitivity of 84.3% and a specificity of 91.7%. Conclusion: AT, ET and AT/ET ratio are useful to identify severe AS.

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