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- W2014771128 abstract "Up to 30% of the patients with aortic stenosis (AS) and preserved LV ejection fraction (LVEF) have a discrepancy among the echocardiographic parameters of stenosis severity, the most frequent being an aortic valve area (AVA) < 1.0 cm2 consistent with severe stenosis and mean gradient (MG) < 40 mm Hg consistent with non-severe stenosis. Measurement of aortic valve calcification (AVC) by computed tomography (CT) correlates well with echocardiographic parameters of AS severity and it has been shown to be useful to corroborate stenosis severity in patients with discordant grading at echocardiography. However, the impact of the aortic valve phenotype (i.e. bicuspid vs. tricuspid) on this relationship between AVC and hemodynamic severity of AS remains unknown. The aims of this study were to evaluate relationship and concordance between echocardiographic and CT parameters of AS severity, with respect to aortic valve phenotype. 188 patients with AS and preserved LVEF were prospectively recruited in the PROGRESSA study (Clinical Trial register: NCT01679431) and underwent a comprehensive Doppler-echocardiography and CT scan. Echocardiographic parameters of AS severity included MG, AVA and indexed AVA (AVAi). AVC was determined by the Agatston method and indexed to the LV outflow tract area (i.e. AVC density: AVCd). The stenosis was considered severe when AVCd was ≥300 AU/cm2 in women and ≥500 AU/cm2 in men as previously described. AVCd correlated well with the echocardiographic parameters of stenosis severity (r>0.53; p<0.0001) in the patients with tricuspid valve but there was no significant correlation in the patients with a bicuspid valve (r<0.14; p>0.40). Of note, 5 of the 38 patients (13%) with a bicuspid valve had very low AVCd (<4 AU/cm2) despite the presence of at least moderate AS on echocardiography confirmed by several parameters including the gradient (MG>20mmHg). Although AVC measured by CT may be useful to corroborate stenosis severity in patients with discordant echocardiographic findings, this parameter should be used with caution in patients with a bicuspid valve given that it may yield to false negative result in about 10-15% of the cases." @default.
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- W2014771128 date "2014-10-01" @default.
- W2014771128 modified "2023-09-27" @default.
- W2014771128 title "IMPACT OF BICUSPID VERSUS TRICUSPID AORTIC VALVE PHENOTYPE ON THE RELATIONSHIP BETWEEN AORTIC VALVE CALCIFICATION MEASURED BY CT AND THE DOPPLER-ECHOCARDIOGRAPHIC PARAMETERS OF AORTIC STENOSIS SEVERITY -PROGRESSA STUDY" @default.
- W2014771128 doi "https://doi.org/10.1016/j.cjca.2014.07.444" @default.
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