Flow Dependence of Valve Area in Aortic Stenosis: Relation to Valve Morphology

Objectives. We sought to develop an index of flow dependence of valve area in aortic valve (AoV) stenosis and to determine whether this index is related to structural characteristics of the diseased valve. Background. Many studies of AoV stenosis using Gorlin or continuity equation methods have demo...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1998-03, Vol.31 (3), p.654-660
Main Authors: Shively, Bruce K, Charlton, Gerald A, Crawford, Michael H, Chaney, Rachel K
Format: Article
Language:English
Subjects:
Adrenergic beta-Agonists
Aged
Aged, 80 and over
Aortic Valve - diagnostic imaging
Aortic Valve - pathology
Aortic Valve - physiopathology
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - pathology
Aortic Valve Stenosis - physiopathology
Biological and medical sciences
Blood Flow Velocity
Cardiology. Vascular system
Confounding Factors (Epidemiology)
Dobutamine
Echocardiography, Doppler - methods
Echocardiography, Transesophageal
Endocardial and cardiac valvular diseases
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Regression Analysis
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Summary:Objectives. We sought to develop an index of flow dependence of valve area in aortic valve (AoV) stenosis and to determine whether this index is related to structural characteristics of the diseased valve. Background. Many studies of AoV stenosis using Gorlin or continuity equation methods have demonstrated flow dependence (an increase in valve area with increased flow). Variation in flow dependence between patients despite similar flow rates remains unexplained. Methods. Dobutamine Doppler echocardiography was used to calculate flow rate and valve area by the continuity equation in 27 patients with aortic stenosis. For each patient the slope of the regression line of valve area to flow rate was determined (slope of flow dependence). Transesophageal echocardiography was used to evaluate features of valve morphology potentially related to the etiology of AoV stenosis and the mechanism of flow dependence. Results. Mean slope of flow dependence was 0.28 cm2/100 ml per s (range −0.06 to 0.53); flow dependence was significantly >0 in 21 patients and was lower for bicuspid valves (slope 0.21 cm2/100 ml per s) than for tricuspid valves with
ISSN:0735-1097
1558-3597
DOI:10.1016/S0735-1097(97)00532-9