دورية أكاديمية
أعرض في EDS

High- versus low-gradient aortic stenosis: Is our evaluation limited by aorto-mitral angle on cardiovascular CT?

التفاصيل البيبلوغرافية
العنوان: High- versus low-gradient aortic stenosis: Is our evaluation limited by aorto-mitral angle on cardiovascular CT?
المؤلفون: See C; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA., Kim Y; Division of Cardiovascular Medicine, Newark Beth Israel Medical Center and New Jersey Medical School, Newark, NJ, USA., Park J; Cardiology Department, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Wang Y; Division of Cardiovascular Diseases and Hypertension, Robert Wood Johnson University Hospital and Robert Wood Johnson Medical School, New Brunswick, NJ, USA., Reinhardt SW; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA., Shkolnik E; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA., Faridi KF; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA., Lombo B; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA., Bellumkonda L; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA., McNamara RL; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA., Sugeng L; Division of Cardiology, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA., Hur DJ; Section of Cardiovascular Medicine, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT, USA; Division of Cardiology, VA Connecticut Healthcare System, West Haven, CT, USA. Electronic address: david.hur@yale.edu.
المصدر: International journal of cardiology [Int J Cardiol] 2024 Aug 15; Vol. 409, pp. 132174. Date of Electronic Publication: 2024 May 14.
نوع المنشور: Journal Article; Comparative Study
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8200291 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1874-1754 (Electronic) Linking ISSN: 01675273 NLM ISO Abbreviation: Int J Cardiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Amsterdam : Elsevier
Original Publication: Amsterdam : Elsevier/North-Holland Biomedical Press, c1981-
مواضيع طبية MeSH: Aortic Valve Stenosis*/diagnostic imaging, Humans ; Male ; Female ; Aged ; Aged, 80 and over ; Retrospective Studies ; Mitral Valve/diagnostic imaging ; Aortic Valve/diagnostic imaging ; Echocardiography/methods ; Tomography, X-Ray Computed/methods ; Severity of Illness Index ; Transcatheter Aortic Valve Replacement/methods
مستخلص: Background: Accurate assessment of aortic valve (AV) stenosis (AS) on transthoracic echocardiogram is crucial for appropriate clinical management. However, discordance between aortic valve area (AVA) and Doppler can complicate the diagnosis of severe AS in low-gradient (LG) AS phenotypes.
Methods: We reviewed 220 consecutive patients with suspected severe AS and AVA ≤1.0 cm 2 on transthoracic echocardiogram who were evaluated for transcatheter AV replacement (TAVR) within a large health system from 2015 to 2019. We compared AV calcium score and aorto-mitral angle (AMA) on 3-chamber views from ECG-gated cardiovascular CT among patients with high-gradient (HG) AS (N = 19), paradoxical low-flow low-gradient (PLFLG) AS (N = 24) and normal-flow low-gradient (NFLG) AS (N = 14).
Results: All groups had comparable age, comorbidities, and AV calcium scores. Compared to patients with HG AS (mean AMA 120 ± 10°), those with PLFLG AS (104 ± 12°; p < 0.001) and NFLG AS (106 ± 13°; p = 0.008) had narrower mean AMA values on cardiovascular CT.
Conclusion: LG AS patients have significantly narrower AMA than HG AS patients on cardiovascular CT. Due to difficulty obtaining parallel Doppler alignment, narrower AMA may contribute to AVA-Doppler discordance on echocardiogram. These findings emphasize the need for additional information in the setting of LG AS.
Competing Interests: Declaration of competing interest Dr. Kamil Faridi receives research funding from the National Institutes of Health/National Heart, Lung, and Blood Institute (K23HL161424), outside the scope of the current work. Dr. David Hur receives research support from the National Institutes of Health/National Heart, Lung, and Blood Institute (R01HL168473), outside the scope of the current work. The remaining authors have no conflicts of interest relevant to this manuscript.
(Published by Elsevier B.V.)
فهرسة مساهمة: Keywords: Aortic stenosis; Aorto-mitral angle; CT; Calcium score; High gradient; Low gradient
تواريخ الأحداث: Date Created: 20240516 Date Completed: 20240615 Latest Revision: 20240615
رمز التحديث: 20240616
DOI: 10.1016/j.ijcard.2024.132174
PMID: 38754590
قاعدة البيانات: MEDLINE
الوصف
تدمد:1874-1754
DOI:10.1016/j.ijcard.2024.132174