Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography

Linnea Hornbech Larsen; Klaus Fuglsang Kofoed; Helle Gervig Carstensen; Mads Rams Mejdahl; Mads Jønsson Andersen; Jesper Kjaergaard; Olav Wendelboe Nielsen; Lars Køber; Rasmus Møgelvang; Christian Hassager

doi:10.1007/s10554-013-0295-6

Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography

Linnea Hornbech Larsen, Klaus Fuglsang Kofoed, Helle Gervig Carstensen, Mads Rams Mejdahl, Mads Jønsson Andersen, Jesper Kjaergaard, Olav Wendelboe Nielsen, Lars Køber, Rasmus Møgelvang, Christian Hassager

Department of Clinical Medicine

14 Citations (Scopus)

Abstract

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 (AVA_MDCT) and by the continuity equation with TTE (AVA _TTE). To generate a reference AVA (AVA_REF) 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). AVA_REF 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 AVA_TTE was 0.93 (±0.33) cm², mean AVA_MDCT was 0.99 (±0.36) cm² and mean AVA_REF was 1.00 (±0.39) cm ². The mean difference between AVA_TTE and AVA _MDCT was -0.06 cm², p = 0.001, mean difference between AVA_TTE and AVA_REF was -0.06 cm², p < 0.001, and mean difference between AVA_MDCT and AVA_REF was -0.01 cm², p = 0.60. Calcification of the aortic valve quantified by Agatston score, significantly decreased the correlation between AVA _MDCT and AVA_REF, (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 AVA_MDCT.

Original language	English
Journal	International Journal of Cardiovascular Imaging
Volume	30
Issue number	1
Pages (from-to)	165-173
Number of pages	9
ISSN	1569-5794
DOIs	https://doi.org/10.1007/s10554-013-0295-6
Publication status	Published - Jan 2014

Keywords

Aged
Aged, 80 and over
Aortic Valve
Aortic Valve Stenosis
Calcinosis
Echocardiography, Doppler
Female
Humans
Male
Middle Aged
Multidetector Computed Tomography
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Severity of Illness Index

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Larsen, L. H., Kofoed, K. F., Carstensen, H. G., Mejdahl, M. R., Andersen, M. J., Kjaergaard, J., Nielsen, O. W., Køber, L., Møgelvang, R., & Hassager, C. (2014). Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography. International Journal of Cardiovascular Imaging, 30(1), 165-173. https://doi.org/10.1007/s10554-013-0295-6

Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography. / Larsen, Linnea Hornbech; Kofoed, Klaus Fuglsang; Carstensen, Helle Gervig et al.
In: International Journal of Cardiovascular Imaging, Vol. 30, No. 1, 01.2014, p. 165-173.

Research output: Contribution to journal › Journal article › Research › peer-review

Larsen, LH, Kofoed, KF, Carstensen, HG, Mejdahl, MR, Andersen, MJ, Kjaergaard, J, Nielsen, OW , Køber, L, Møgelvang, R & Hassager, C 2014, 'Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography', International Journal of Cardiovascular Imaging, vol. 30, no. 1, pp. 165-173. https://doi.org/10.1007/s10554-013-0295-6

@article{de18d04826a94571bb1d8b9a6a51ce52,

title = "Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography",

abstract = "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.",

keywords = "Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Calcinosis, Echocardiography, Doppler, Female, Humans, Male, Middle Aged, Multidetector Computed Tomography, Predictive Value of Tests, Radiographic Image Interpretation, Computer-Assisted, Severity of Illness Index",

author = "Larsen, {Linnea Hornbech} and Kofoed, {Klaus Fuglsang} and Carstensen, {Helle Gervig} and Mejdahl, {Mads Rams} and Andersen, {Mads J{\o}nsson} and Jesper Kjaergaard and Nielsen, {Olav Wendelboe} and Lars K{\o}ber and Rasmus M{\o}gelvang and Christian Hassager",

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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.

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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 -

Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography

Abstract

Keywords

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