TY - JOUR
T1 - Aortic valve area assessed with 320-detector computed tomography
T2 - comparison with transthoracic echocardiography
AU - Larsen, Linnea Hornbech
AU - Kofoed, Klaus Fuglsang
AU - Carstensen, Helle Gervig
AU - Mejdahl, Mads Rams
AU - Andersen, Mads Jønsson
AU - Kjaergaard, Jesper
AU - Nielsen, Olav Wendelboe
AU - Køber, Lars
AU - Møgelvang, Rasmus
AU - Hassager, Christian
PY - 2014/1
Y1 - 2014/1
N2 - To evaluate the diagnostic accuracy of aortic valve area (AVA) assessment with 320-detector Computed Tomography (MDCT) compared to transthoracic echocardiography (TTE) in a population with mild to severe aortic valve stenosis. AVA was estimated in 169 patients by planimetry on MDCT images (AVAMDCT) and by the continuity equation with TTE (AVA TTE). To generate a reference AVA (AVAREF) we used the stroke volume from MDCT divided by the velocity time integral from CW Doppler by TTE (according to the continuity equation: stroke volume in LVOT = stroke volume passing the aortic valve). AVAREF was used as the reference to compare both measures against, since it bypasses the assumption of LVOT being circular in the continuity equation and the potential placement error of PW Doppler in the LVOT. The mean (±SD) age of the patients was 71 (±9) years, 113 (67%) were males. Mean AVATTE was 0.93 (±0.33) cm2, mean AVAMDCT was 0.99 (±0.36) cm2 and mean AVAREF was 1.00 (±0.39) cm 2. The mean difference between AVATTE and AVA MDCT was -0.06 cm2, p = 0.001, mean difference between AVATTE and AVAREF was -0.06 cm2, p < 0.001, and mean difference between AVAMDCT and AVAREF was -0.01 cm2, p = 0.60. Calcification of the aortic valve quantified by Agatston score, significantly decreased the correlation between AVA MDCT and AVAREF, (r low Agatston = 0.90, r high Agatston = 0.57). MDCT measured AVA is slightly larger than AVA measured by TTE (0.06 cm2). The accuracy and precision errors on AVA measurements are comparable for MDCT and TTE. Valvular calcification may primarily affect the accuracy of AVAMDCT.
AB - To evaluate the diagnostic accuracy of aortic valve area (AVA) assessment with 320-detector Computed Tomography (MDCT) compared to transthoracic echocardiography (TTE) in a population with mild to severe aortic valve stenosis. AVA was estimated in 169 patients by planimetry on MDCT images (AVAMDCT) and by the continuity equation with TTE (AVA TTE). To generate a reference AVA (AVAREF) we used the stroke volume from MDCT divided by the velocity time integral from CW Doppler by TTE (according to the continuity equation: stroke volume in LVOT = stroke volume passing the aortic valve). AVAREF was used as the reference to compare both measures against, since it bypasses the assumption of LVOT being circular in the continuity equation and the potential placement error of PW Doppler in the LVOT. The mean (±SD) age of the patients was 71 (±9) years, 113 (67%) were males. Mean AVATTE was 0.93 (±0.33) cm2, mean AVAMDCT was 0.99 (±0.36) cm2 and mean AVAREF was 1.00 (±0.39) cm 2. The mean difference between AVATTE and AVA MDCT was -0.06 cm2, p = 0.001, mean difference between AVATTE and AVAREF was -0.06 cm2, p < 0.001, and mean difference between AVAMDCT and AVAREF was -0.01 cm2, p = 0.60. Calcification of the aortic valve quantified by Agatston score, significantly decreased the correlation between AVA MDCT and AVAREF, (r low Agatston = 0.90, r high Agatston = 0.57). MDCT measured AVA is slightly larger than AVA measured by TTE (0.06 cm2). The accuracy and precision errors on AVA measurements are comparable for MDCT and TTE. Valvular calcification may primarily affect the accuracy of AVAMDCT.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve
KW - Aortic Valve Stenosis
KW - Calcinosis
KW - Echocardiography, Doppler
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Multidetector Computed Tomography
KW - Predictive Value of Tests
KW - Radiographic Image Interpretation, Computer-Assisted
KW - Severity of Illness Index
U2 - 10.1007/s10554-013-0295-6
DO - 10.1007/s10554-013-0295-6
M3 - Journal article
C2 - 24126620
SN - 1569-5794
VL - 30
SP - 165
EP - 173
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 1
ER -