Inconsistency in aortic stenosis severity between CT and echocardiography: prevalence and insights into mechanistic differences using computational fluid dynamics

ObjectivesThe aims of this study were to evaluate the inconsistency of aortic stenosis (AS) severity between CT aortic valve area (CT-AVA) and echocardiographic Doppler parameters, and to investigate potential underlying mechanisms using computational fluid dynamics (CFD).MethodsA total of 450 conse...

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Bibliographic Details
Published in:Open heart 2019, Vol.6 (2), p.e001044-e001044
Main Authors: Mittal, Tarun Kumar, Reichmuth, Luise, Bhattacharyya, Sanjeev, Jain, Manish, Baltabaeva, Aigul, Rahman Haley, Shelley, Mirsadraee, Saeed, Panoulas, Vasileios, Kabir, Tito, Nicol, Edward David, Dalby, Miles, Long, Quan
Format: Article
Language:English
Subjects:
Accuracy
Calcification
Clinical medicine
Electrocardiography
Flow velocity
Fluid dynamics
Fluid mechanics
Heart
Medical imaging
Studies
Valvular Heart Disease
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Summary:ObjectivesThe aims of this study were to evaluate the inconsistency of aortic stenosis (AS) severity between CT aortic valve area (CT-AVA) and echocardiographic Doppler parameters, and to investigate potential underlying mechanisms using computational fluid dynamics (CFD).MethodsA total of 450 consecutive eligible patients undergoing transcatheter AV implantation assessment underwent CT cardiac angiography (CTCA) following echocardiography. CT-AVA derived by direct planimetry and echocardiographic parameters were used to assess severity. CFD simulation was performed in 46 CTCA cases to evaluate velocity profiles.ResultsA CT-AVA>1 cm2 was present in 23% of patients with echocardiographic peak velocity≥4 m/s (r=−0.33) and in 15% patients with mean Doppler gradient≥40 mm Hg (r=−0.39). Patients with inconsistent severity grading between CT and echocardiography had higher stroke volume index (43 vs 38 mL/m2, p
ISSN:2053-3624
2398-595X
2053-3624
DOI:10.1136/openhrt-2019-001044