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Circulation, Vol 72, 810-818, Copyright © 1985 by American Heart Association
T Skjaerpe, L Hegrenaes and L Hatle
In 30 patients with aortic stenosis, 14 of whom also had significant aortic
regurgitation, the velocities in the stenotic jet (V') and below the valve
(V) were recorded by Doppler ultrasound. With two-dimensional
echocardiography, two subvalvular areas (A) were calculated from
leading-to-leading edge ("large") and trailing-to-leading edge ("inner")
diameter measurements. The aortic valve area was calculated by the equation
of continuity (A' = A X peak V/peak V') and by calculating stroke volume
below the valve [A X integral of V (t) and dividing by the integral of V'
(t) (= A"). Based on cardiac output estimations from single-plane
angiographic images, Gorlin's formula was used to calculate invasive valve
areas. In patients with no or mild aortic regurgitation a second invasive
estimate was based on cardiac output measured by the Fick method. The best
correlation was found when A' (with "large" diameter) was compared with
invasive results based on cardiac output measured by the Fick method (r =
.89, SEE +/- 0.12, n = 16); the worst was found when A" (with "large"
diameter) was compared with invasive results based on cardiac output
measurements by single- plane angiography (r = .80, SEE +/- 0.20, n = 30).
The results indicate that valve area in patients with aortic stenosis can
be reliably estimated noninvasively, even in those with significant aortic
regurgitation.
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