Geometry of the left ventricular outflow tract assessed by 3D TEE in patients with aortic stenosis: impact of upper septal ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-05-24

AUTHORS

Dan Koto, Masaki Izumo, Takafumi Machida, Kengo Suzuki, Kihei Yoneyama, Tomomi Suzuki, Ryo Kamijima, Yasuyuki Kobayashi, Tomoo Harada, Yoshihiro J. Akashi

ABSTRACT

BackgroundIt is unclear how upper septal hypertrophy (USH) affects Doppler-derived left ventricular stroke volume (SV) in patients with AS. The aims of this study were to: (1) validate the accuracy of 3D transesophageal echocardiography (TEE) measurements of the left ventricular outflow tract (LVOT), (2) evaluate the differences in LVOT geometry between AS patients with and without USH, and (3) assess the impact of USH on measurement of SV.MethodsIn protocol 1, both 3D TEE and multi-detector computed tomography were performed in 20 patients with AS [aortic valve area (AVA) ≤ 1.5 cm2]. Multiplanar reconstruction was used to measure the LVOT short and long diameters in four parts from the tip of the septum to the annulus. In protocol 2, the same 3D TEE measurements were performed in AS patients (AVA ≤ 1.5 cm2, n = 129) and controls (n = 30). We also performed 2D and 3D transthoracic echocardiography in all patients.ResultsIn protocol 1, excellent correlations of LVOT parameters were found between the two modalities. In protocol 2, the USH group had smaller LVOT short and long diameters than the non-USH group. Although no differences in mean pressure gradient, or SV calculated with the 3D method existed between the two groups, the USH group had greater SV calculated with the Doppler method (73 ± 15 vs. 66 ± 15 ml) and aortic valve area (0.89 ± 0.26 vs. 0.73 ± 0.24 cm2) than the non-USH group.Conclusions3D TEE can provide a precise assessment of the LVOT in AS. USH affects the LVOT geometry in patients with AS, which might lead to inaccurate assessments of disease severity. More... »

PAGES

162-172

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12574-018-0383-7

DOI

http://dx.doi.org/10.1007/s12574-018-0383-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1104156733

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29797230


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