Echocardiographic and electron beam tomographic assessment of stenosis in patients with aortic valve disease: gradient versus valve area

Neth Heart J. 2006 Oct;14(10):325-329.

Abstract

Background: Transthoracic echocardiography (TTE) is routinely used to evaluate aortic valve stenosis. However, it does not give reliable results in every patient. There is growing interest in electron-beam tomography (EBT) as a noninvasive cardiac imaging technique. The usefulness of EBT to evaluate aortic stenosis has yet to be evaluated.

Aim: To compare EBT with TTE in assessing severity of aortic stenosis.

Methods: In total 47 patients (18 females, 29 males) underwent a contrast-enhanced EBT scan and TTE within 6±20 days. The calcium score of the aortic valve was determined and the aortic valve area (AVA) was measured by planimetry. A complete TTE study, during which the peak pressure gradient across the aortic valve was measured, was performed in all patients by an experienced sonographer.

Results: There was a significant correlation between AVA assessed by EBT and peak pressure gradient (r=-0.38, p=0.009). The calcium score of the aortic valve assessed by EBT correlated with peak pressure gradient (r=0.48, p=0.001).

Conclusion: EBT is a useful noninvasive method to evaluate the severity of aortic stenosis. It holds the possibility of assessing the AVA as well as quantification of the degree of calcification.

Keywords: aortic valve disease; echocardiography; electron-beam tomography.