Validity of visual assessment of aortic valve morphology in patients with aortic stenosis using two-dimensional echocard
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ORIGINAL PAPER
Validity of visual assessment of aortic valve morphology in patients with aortic stenosis using two-dimensional echocardiography Olena Nemchyna1 · Sajjad Soltani1 · Natalia Solowjowa1 · Felix Schoenrath1,2 · Yuriy Hrytsyna1 · Axel Unbehaun1,2 · Jörg Kempfert1,2 · Julia Stein1 · Christoph Knosalla1,2 · Andreas Hagendorff5 · Fabian Knebel6 · Volkmar Falk1,2,3,4 · Jan Knierim1 Received: 16 June 2020 / Accepted: 26 September 2020 © The Author(s) 2020
Abstract The diagnostic value of a visual assessment of aortic valve (AV) morphology for grading aortic stenosis (AS) remains unclear. A visual score (VS) for assessing the AV was developed and its reliability with respect to Doppler measurements and the calcium score (ctCS) derived by multislice computed tomography was evaluated. 99 Patients with AS of various severity and 38 patients without AS were included in the analysis. Echocardiographic studies were evaluated using the new VS which includes echogenicity, thickening, localization of lesions and leaflet mobility, with a total score ranging from 0 to 11. The association of VS with ctCS and the severity of AS was analyzed. There was a significant correlation of VS with AV hemodynamic parameters and with ctCS. The cut-off value for the detection of AS of any grade was a VS of 6 (sensitivity 95%, specificity 85% for women; sensitivity 85%, specificity 88% for men). A VS of 9 for women and of 10 for men was able to predict severe AS with a high specificity (96% in women and 94% in men, AUC 0.8 and 0.86, respectively). The same cut-off values were identified for the detection of ctCS of ≥ 1600 AU and ≥ 3000 AU with a specificity of 77% and 82% (AUC 0.69 and 0.81, respectively). Assessment of aortic valve morphology can serve as an additional diagnostic tool for the detection of AS and an estimation of its severity. Keywords Aortic valve stenosis · Two-dimensional echocardiography · Aortic valve calcium score · Visual assessment of aortic stenosis
Olena Nemchyna and Sajjad Soltani contributed equally to first authorship. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10554-020-02048-4) contains supplementary material, which is available to authorized users. * Jan Knierim [email protected] 1
Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
2
DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Hessische Straße 3‑ 4, 10115 Berlin, Germany
3
Department of Cardiothoracic Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
Abbreviations AS Aortic stenosis AV Aortic valve AVA Aortic valve area ctCS Calcium score derived by MSCT LV Left ventricle MSCT Multislice computed tomography 4
Department of Health Sciences and Technology, Translational Cardiovascular Technology, ETH Zurich, LFW C 13.2, Universitätstra
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