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

Detalhes bibliográficos
Autor(a) principal: Teixeira, P
Data de Publicação: 2017
Outros Autores: Ramos, R, Rio, P, Branco, LM, Portugal, G, Abreu, A, Galrinho, A, Marques, H, Figueiredo, L, Cruz Ferreira, R
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.17/3176
Resumo: PURPOSE: 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.
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spelling Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area EstimationAged, 80 and overAortic ValveAortic Valve StenosisBody Weights and MeasuresEchocardiographyEchocardiography, Three-DimensionalEchocardiography, TransesophagealFemaleHeart VentriclesHumansMaleMultidetector Computed TomographyProspective StudiesReproducibility of ResultsSeverity of Illness IndexTranscatheter Aortic Valve ReplacementHSM CARHSM IMAPURPOSE: 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.WileyRepositório do Centro Hospitalar Universitário de Lisboa Central, EPETeixeira, PRamos, RRio, PBranco, LMPortugal, GAbreu, AGalrinho, AMarques, HFigueiredo, LCruz Ferreira, R2019-03-12T15:46:23Z2017-072017-07-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3176engEchocardiography. 2017 Jul;34(7):978-985.10.1111/echo.13589info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:41:39Zoai:repositorio.chlc.min-saude.pt:10400.17/3176Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:30.277570Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
title Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
spellingShingle Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
Teixeira, P
Aged, 80 and over
Aortic Valve
Aortic Valve Stenosis
Body Weights and Measures
Echocardiography
Echocardiography, Three-Dimensional
Echocardiography, Transesophageal
Female
Heart Ventricles
Humans
Male
Multidetector Computed Tomography
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Transcatheter Aortic Valve Replacement
HSM CAR
HSM IMA
title_short Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
title_full Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
title_fullStr Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
title_full_unstemmed Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
title_sort Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area Estimation
author Teixeira, P
author_facet Teixeira, P
Ramos, R
Rio, P
Branco, LM
Portugal, G
Abreu, A
Galrinho, A
Marques, H
Figueiredo, L
Cruz Ferreira, R
author_role author
author2 Ramos, R
Rio, P
Branco, LM
Portugal, G
Abreu, A
Galrinho, A
Marques, H
Figueiredo, L
Cruz Ferreira, R
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE
dc.contributor.author.fl_str_mv Teixeira, P
Ramos, R
Rio, P
Branco, LM
Portugal, G
Abreu, A
Galrinho, A
Marques, H
Figueiredo, L
Cruz Ferreira, R
dc.subject.por.fl_str_mv Aged, 80 and over
Aortic Valve
Aortic Valve Stenosis
Body Weights and Measures
Echocardiography
Echocardiography, Three-Dimensional
Echocardiography, Transesophageal
Female
Heart Ventricles
Humans
Male
Multidetector Computed Tomography
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Transcatheter Aortic Valve Replacement
HSM CAR
HSM IMA
topic Aged, 80 and over
Aortic Valve
Aortic Valve Stenosis
Body Weights and Measures
Echocardiography
Echocardiography, Three-Dimensional
Echocardiography, Transesophageal
Female
Heart Ventricles
Humans
Male
Multidetector Computed Tomography
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Transcatheter Aortic Valve Replacement
HSM CAR
HSM IMA
description PURPOSE: 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.
publishDate 2017
dc.date.none.fl_str_mv 2017-07
2017-07-01T00:00:00Z
2019-03-12T15:46:23Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.17/3176
url http://hdl.handle.net/10400.17/3176
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Echocardiography. 2017 Jul;34(7):978-985.
10.1111/echo.13589
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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