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Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation

2017-07Journal article Open access
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dc.contributor.authorTeixeira, P
dc.contributor.authorRamos, R
dc.contributor.authorRio, P
dc.contributor.authorBranco, LM
dc.contributor.authorPortugal, G
dc.contributor.authorAbreu, A
dc.contributor.authorGalrinho, A
dc.contributor.authorMarques, H
dc.contributor.authorFigueiredo, L
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2019-03-12T15:46:23Z
dc.date.available2019-03-12T15:46:23Z
dc.date.issued2017-07
dc.description.abstractPURPOSE: Aortic valve area (AVA) is usually estimated by the continuity equation (CE) in which the left ventricular outflow tract (LVOT) area is calculated assuming a circular shape. This study aimed to compare measurements of LVOT area using standard 2D transthoracic echocardiography (2DTTE), 3D transesophageal echocardiography (3DTEE), and multidetector computed tomography (MDCT) and assess their relative impact on AVA estimated by the CE. METHODS AND RESULTS: We prospectively enrolled 60 patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) who systematically underwent 2DTTE, 3DTEE, and MDCT. Mean LVOT areas obtained by 2DTTE (3.28±0.66 cm2 ) and 3DTEE (3.95±0.90 cm2 ) were significantly underestimated when compared to the mean MDCT LVOT area (4.31±0.99 cm2 ). LVOT was rather elliptical than round, with a mean eccentricity index of 1.47 (ratio of maximum to minimum LVOT diameters) assessed by MDCT. Mean TTE AVA estimated by the CE was 0.62±0.20 cm2 . Substitution of 2DTTE LVOT area by 3DTEE LVOT area in the CE resulted in AVA of 0.74±0.24 cm2 , while using MDCT LVOT area held an AVA of 0.80±0.24 cm2 . MDCT-derived AVA was similar to MDCT planimetric AVA and allowed 24% of patients to be reclassified from severe to moderate AS. CONCLUSIONS: 2DTTE and 3DTEE underestimate LVOT area when compared to MDCT with significant impact on AVA estimation. Assessment through MDCT fusion AVA may be of incremental value in patients with discrepant severity criteria for AS.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEchocardiography. 2017 Jul;34(7):978-985.pt_PT
dc.identifier.doi10.1111/echo.13589pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3176
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectAortic Valvept_PT
dc.subjectAortic Valve Stenosispt_PT
dc.subjectBody Weights and Measurespt_PT
dc.subjectEchocardiographypt_PT
dc.subjectEchocardiography, Three-Dimensionalpt_PT
dc.subjectEchocardiography, Transesophagealpt_PT
dc.subjectFemalept_PT
dc.subjectHeart Ventriclespt_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMultidetector Computed Tomographypt_PT
dc.subjectProspective Studiespt_PT
dc.subjectReproducibility of Resultspt_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectTranscatheter Aortic Valve Replacementpt_PT
dc.subjectHSM CARpt_PT
dc.subjectHSM IMApt_PT
dc.titleModified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage985pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage978pt_PT
oaire.citation.titleEchocardiographypt_PT
oaire.citation.volume34pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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