In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 1 ( 2023-1-20), p. e0280530-
Abstract:
A certain proportion of patients with severe aortic stenosis (AS) present with discordant grading between different diagnostic modalities, which raises uncertainty about the true severity of AS. The aim of this study was to compare the aortic valve area (AVA) measured on CT and echocardiography and demonstrate the factors affecting AVA discrepancies. Methods Between June 2011 and March 2016, 535 consecutive patients (66.83±8.80 years, 297 men) with AS who underwent pre-operative cardiac CT and echocardiography for aortic valve replacement were retrospectively included. AVA was obtained by AVA on echocardiography (AVA echo ) and CT (AVA CT ) using a measurement of the left ventricular outflow tract on each modality and correlations between those measures were evaluated. Logistic regression analysis was performed to identify factors affecting the discordance for grading severe AS. Results The AVA CT and AVA echo showed a high correlation (r: 0.79, P 〈 0.001) but AVA CT was larger than the AVA echo (difference 0.26 cm 2 , P 〈 0.001). By using the cut-off values of AVA CT ( 〈 1.2 cm 2 ) and AVA echo ( 〈 1.0 cm 2 ) for diagnosing severe AS, the BSA (odds ratio [OR]: 68.03, 95% confidence interval [CI] : 5.45–849.99; P = 0.001), AVA echo (OR: 1.19, 95%CI: 1.14–1.24; P 〈 0.001), tricuspid valve morphology (OR: 2.83, 95%CI: 1.23–6.50; P = 0.01), and normalized annulus area (OR: 1.02; 95%CI:1.02–1.03; P 〈 0.001) were significant factors associated with the discordance between the AVA echo and AVA CT . Conclusion Patients with larger BSA, AVA echo , and annulus, and tricuspid valve morphology were associated with the AVA discordance between the echocardiography and CT. Complementary use of CT with echocardiography for grading severe AS could be helpful in such conditions.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0280530
DOI:
10.1371/journal.pone.0280530.g001
DOI:
10.1371/journal.pone.0280530.g002
DOI:
10.1371/journal.pone.0280530.g003
DOI:
10.1371/journal.pone.0280530.t001
DOI:
10.1371/journal.pone.0280530.t002
DOI:
10.1371/journal.pone.0280530.t003
DOI:
10.1371/journal.pone.0280530.t004
DOI:
10.1371/journal.pone.0280530.t005
DOI:
10.1371/journal.pone.0280530.s001
DOI:
10.1371/journal.pone.0280530.s002
DOI:
10.1371/journal.pone.0280530.s003
DOI:
10.1371/journal.pone.0280530.r001
DOI:
10.1371/journal.pone.0280530.r002
DOI:
10.1371/journal.pone.0280530.r003
DOI:
10.1371/journal.pone.0280530.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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