Echocardiographic Assessment of the Aortic Stenosis Valve Area: Parameters and Outcome

Background: Among individuals who have a stenotic aortic valve, a precise assessment of aortic valve area is essential for clinical judgment. So far, no studies have been conducted to investigate and assess the role of the three dimensional echo-cardiography in the assessment of the valve stenosis. This study aims to compare and assess the precision of the measurement of the stenosis area of the aortic valve by ۲D versus ۳D echo-cardiography.Method: This was a cross-sectional study conducted in Baghdad Medical City, Ministry of Health in Iraq from the ۱st December ۲۰۲۱ to the ۱st June ۲۰۲۲. Aortic valve area was calculated in a cross-sectional study by using transthoracic echo-Doppler, continuity equation, and ۳D and ۳D/۲D planimetr.Results: ۳۳ patients with aortic stenosis were examined. AVA analysis of correlation and absolute agreement revealed the agreement was high and the absolute differences were minimal across all planimetric methods: ۳D vs. ۳D/۲D: ۰.۹۱۳ (۰.۸۲۹–۰.۹۵۷); ۲D vs. ۳D/۲D: ۰.۷۴۷ (۰.۵۳۷–۰.۸۶۹). For AVA evaluation, the correlation coefficient r between ۳D and ۲D was (۰.۹۰۲) and (۰.۷۲۹), respectively. The observer variability was equal for all approaches, while the ۳D inter-observer variability was higher than for ۲D techniques (p = ۰.۰۳۶).Conclusion: The ۳D/۲D echo techniques for AVA planimetry agreed with the traditional ۲D methodology and flow-derived methods. When compared with ۲D AVA on the principle of continuity equation, the ۳D approach was at least as excellent as the ۲D method and had a greater repeatability. Using ۳D Echo in the evaluation of aortic valve area is a not-invasive procedure leading to the AS quantitative assessment that is accurate and reliable.

Keywords:

Aortic stenosis , echocardiography , ۳D/۲D