Tissue Doppler imaging in patients with moderate to severe aortic valve stenosis: Clinical usefulness and diagnostic accuracy
Section snippets
Study population
To address these objectives, study participants were selected from 51 patients with moderate (aortic valve area > 1.0 to 1.5 cm2) or severe AS (area < 1.0 cm2)12 undergoing clinically indicated left and right heart catheterization in our institution (Hospital of the University of Münster).
Subjects with atrial fibrillation (n = 6), single- or dual-chamber pacemaker (n = 3), left bundle branch block (n = 4), mitral stenosis or regurgitation ≥2° (n = 4), aortic valve regurgitation ≥2° (n = 5),
Clinical data
Patient demographics are given in Table I.The two study groups and the control group did not differ significantly with respect to age, heart rate, body surface area, and systolic or diastolic blood pressure. In patients with AS, the mean valve area was 0.8 ± 0.4 cm2. In 6 patients, stenosis was moderate (valve area, 1.2 ± 0.2 cm2); in 17 patients, stenosis was severe (area, 0.6 ± 0.4 cm2). Four of 23 patients with AS (17%) had a bicuspid valve. In 19 patients with AS (83%), signs or symptoms
Discussion
Our study is the first to study the usefulness of the mitral E/E' ratio as an estimate of LV filling pressures in patients with AS and to validate it against invasive measurements derived from cardiac catheterization. The main finding is that the E/E' ratio allows for a readily derived, reliable, and reproducible estimation of LV filling pressures in patients with AS with mild to moderate stenosis. Furthermore, in our study, TDI provided evidence for impaired systolic long-axis function in
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