The Diagnostic Role of "acceleration Time" Measurement in Patients with Classical Low Flow Low Gradient Aortic Stenosis with Reduced Left Ventricular Ejection Fraction

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2022 Nov 17

PMID 36394680

Authors

Kadriye Memic Sancar

Gamze Babur Guler

Halil Ibrahim Tanboga

Aysel Turkvatan Cansever

Ali Riza Demir

Arda Guler

Meltem Tekin

Begum Uygur

Ali Birant

Yalcin Avci

Ekrem Guler

Mehmet Erturk

Affiliations

Soon will be listed here.

Abstract

Purpose: In our study, we aimed to assess the role of acceleration time (AT), ejection time (ET), and AT/ET ratio to distinguish between true and pseudo severe AS in patients with classical low flow-low gradient (LF-LG) aortic stenosis (AS) with reduced left ventricular ejection fraction (LVEF).

Methods: Sixty-seven classical LF-LG AS with reduced LVEF patients who underwent dobutamine stress echocardiography (DSE) were included in the study. According to DSE results, all patients were divided into two groups; true AS and pseudo severe AS. Aortic valve calcium score was measured in patients with inconclusive DSE results. AT and other ejection dynamics (ET and AT/ET) were calculated by taking baseline echocardiographic records into account for all patients. The predictive power of AT and other ejection dynamics were evaluated to estimate true and pseudo severe AS.

Results: According to DSE results, out of 67 patients, 44 (65.7%) was diagnosed as true severe AS. There was a statistically significant relation between baseline AT and true AS [adjusted OR 4.47 (95% CI 1.93-10.4), p = 0.001]. The best cutoff value of AT was measured as 100 msec according to the Youden index. This value had a sensitivity value of 77%, specificity value of 87%, positive predictive value of 92%, and a negative predictive value of 67%.

Conclusion: The measurement of AT can predict the DSE outcome and can be used for diagnostic purposes to distinguish between true and pseudo severe AS in classical LF-LG AS patients with reduced LVEF.

Citing Articles

Aortic Valve Calcium Score: Applications in Clinical Practice and Scientific Research-A Narrative Review.

Gac P, Jaworski A, Grajnert F, Kicman K, Trejtowicz-Sutor A, Witkowski K J Clin Med. 2024; 13(14).

PMID: 39064103 PMC: 11277735. DOI: 10.3390/jcm13144064.

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