Assessment of aortic stenosis by three-dimensional echocardiography: An accurate and novel approach

Sorel Goland, Alfredo Trento, Kiyoshi Iida, Lawrence S C Czer, Michele De Robertis, Tasneem Zehra Naqvi, Kirsten Tolsfrup, Takashi Akima, Huai Luo, Robert J. Siegel

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Abstract

Background: Accurate assessment of aortic valve area (AVA) is important for clinical decision-making in patients with aortic valve stenosis (AS). The role of three-dimensional echocardiography (3D) in the quantitative assessment of AS has not been evaluated so far. Objectives: To evaluate the reproducibility and accuracy of real-time three-dimensional echocardiography (RT3D) and 3D-guided two-dimensional planimetry (3D/2D) for assessment of AS, and compare these results with those of standard echocardiography and cardiac catheterisation (Cath). Methods: AVA was estimated by transthoracic echo-Doppler (TTE) and by direct planimetry using transoesophageal echocardiography (TEE) as well as RT3D and 3D/2D. 15 patients underwent assessment of AS by Cath. Results: 33 patients with AS were studied (20 men, mean (SD) age 70 (14) years). Bland-Altman analysis showed good agreement and small absolute differences in AVA between all planimetric methods (RT3D vs 3D/2D: -0.01 (0.15) cm2; 3D/2D vs TEE: 0.05 (0.22) cm2; RT3D vs TEE: 0.06 (0.26) cm2). The agreement between AVA assessment by 2D-TTE and planimetry was -0.01 (0.20) cm2 for 3D/2D; 0.00 (0.15) cm2 for RT3D; and -0.05 (0.30) cm2 for TEE. Correlation coefficient r for AVA assessment between each of 3D/2D, RT3D, TEE planimetry and Cath was 0.81, 0.86 and 0.71, respectively. The intraobserver variability was similar for all methods, but interobserver variability was better for 3D techniques than for TEE (p<0.05). Conclusions: The 3D echo methods for planimetry of the AVA showed good agreement with the standard TEE technique and flow-derived methods. Compared with AV planimetry by TEE, both 3D methods were at least as good as TEE and had better reproducibility. 3D aortic valve planimetry is a novel non-invasive technique, which provides an accurate and reliable quantitative assessment of AS.

Original languageEnglish (US)
Pages (from-to)801-807
Number of pages7
JournalHeart
Volume93
Issue number7
DOIs
StatePublished - Jul 2007
Externally publishedYes

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Three-Dimensional Echocardiography
Transesophageal Echocardiography
Aortic Valve Stenosis
Aortic Valve
Observer Variation
Catheterization
Cardiac Catheterization
Echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Goland, S., Trento, A., Iida, K., Czer, L. S. C., De Robertis, M., Naqvi, T. Z., ... Siegel, R. J. (2007). Assessment of aortic stenosis by three-dimensional echocardiography: An accurate and novel approach. Heart, 93(7), 801-807. https://doi.org/10.1136/hrt.2006.110726

Assessment of aortic stenosis by three-dimensional echocardiography : An accurate and novel approach. / Goland, Sorel; Trento, Alfredo; Iida, Kiyoshi; Czer, Lawrence S C; De Robertis, Michele; Naqvi, Tasneem Zehra; Tolsfrup, Kirsten; Akima, Takashi; Luo, Huai; Siegel, Robert J.

In: Heart, Vol. 93, No. 7, 07.2007, p. 801-807.

Research output: Contribution to journalArticle

Goland, S, Trento, A, Iida, K, Czer, LSC, De Robertis, M, Naqvi, TZ, Tolsfrup, K, Akima, T, Luo, H & Siegel, RJ 2007, 'Assessment of aortic stenosis by three-dimensional echocardiography: An accurate and novel approach', Heart, vol. 93, no. 7, pp. 801-807. https://doi.org/10.1136/hrt.2006.110726
Goland, Sorel ; Trento, Alfredo ; Iida, Kiyoshi ; Czer, Lawrence S C ; De Robertis, Michele ; Naqvi, Tasneem Zehra ; Tolsfrup, Kirsten ; Akima, Takashi ; Luo, Huai ; Siegel, Robert J. / Assessment of aortic stenosis by three-dimensional echocardiography : An accurate and novel approach. In: Heart. 2007 ; Vol. 93, No. 7. pp. 801-807.
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abstract = "Background: Accurate assessment of aortic valve area (AVA) is important for clinical decision-making in patients with aortic valve stenosis (AS). The role of three-dimensional echocardiography (3D) in the quantitative assessment of AS has not been evaluated so far. Objectives: To evaluate the reproducibility and accuracy of real-time three-dimensional echocardiography (RT3D) and 3D-guided two-dimensional planimetry (3D/2D) for assessment of AS, and compare these results with those of standard echocardiography and cardiac catheterisation (Cath). Methods: AVA was estimated by transthoracic echo-Doppler (TTE) and by direct planimetry using transoesophageal echocardiography (TEE) as well as RT3D and 3D/2D. 15 patients underwent assessment of AS by Cath. Results: 33 patients with AS were studied (20 men, mean (SD) age 70 (14) years). Bland-Altman analysis showed good agreement and small absolute differences in AVA between all planimetric methods (RT3D vs 3D/2D: -0.01 (0.15) cm2; 3D/2D vs TEE: 0.05 (0.22) cm2; RT3D vs TEE: 0.06 (0.26) cm2). The agreement between AVA assessment by 2D-TTE and planimetry was -0.01 (0.20) cm2 for 3D/2D; 0.00 (0.15) cm2 for RT3D; and -0.05 (0.30) cm2 for TEE. Correlation coefficient r for AVA assessment between each of 3D/2D, RT3D, TEE planimetry and Cath was 0.81, 0.86 and 0.71, respectively. The intraobserver variability was similar for all methods, but interobserver variability was better for 3D techniques than for TEE (p<0.05). Conclusions: The 3D echo methods for planimetry of the AVA showed good agreement with the standard TEE technique and flow-derived methods. Compared with AV planimetry by TEE, both 3D methods were at least as good as TEE and had better reproducibility. 3D aortic valve planimetry is a novel non-invasive technique, which provides an accurate and reliable quantitative assessment of AS.",
author = "Sorel Goland and Alfredo Trento and Kiyoshi Iida and Czer, {Lawrence S C} and {De Robertis}, Michele and Naqvi, {Tasneem Zehra} and Kirsten Tolsfrup and Takashi Akima and Huai Luo and Siegel, {Robert J.}",
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T1 - Assessment of aortic stenosis by three-dimensional echocardiography

T2 - An accurate and novel approach

AU - Goland, Sorel

AU - Trento, Alfredo

AU - Iida, Kiyoshi

AU - Czer, Lawrence S C

AU - De Robertis, Michele

AU - Naqvi, Tasneem Zehra

AU - Tolsfrup, Kirsten

AU - Akima, Takashi

AU - Luo, Huai

AU - Siegel, Robert J.

PY - 2007/7

Y1 - 2007/7

N2 - Background: Accurate assessment of aortic valve area (AVA) is important for clinical decision-making in patients with aortic valve stenosis (AS). The role of three-dimensional echocardiography (3D) in the quantitative assessment of AS has not been evaluated so far. Objectives: To evaluate the reproducibility and accuracy of real-time three-dimensional echocardiography (RT3D) and 3D-guided two-dimensional planimetry (3D/2D) for assessment of AS, and compare these results with those of standard echocardiography and cardiac catheterisation (Cath). Methods: AVA was estimated by transthoracic echo-Doppler (TTE) and by direct planimetry using transoesophageal echocardiography (TEE) as well as RT3D and 3D/2D. 15 patients underwent assessment of AS by Cath. Results: 33 patients with AS were studied (20 men, mean (SD) age 70 (14) years). Bland-Altman analysis showed good agreement and small absolute differences in AVA between all planimetric methods (RT3D vs 3D/2D: -0.01 (0.15) cm2; 3D/2D vs TEE: 0.05 (0.22) cm2; RT3D vs TEE: 0.06 (0.26) cm2). The agreement between AVA assessment by 2D-TTE and planimetry was -0.01 (0.20) cm2 for 3D/2D; 0.00 (0.15) cm2 for RT3D; and -0.05 (0.30) cm2 for TEE. Correlation coefficient r for AVA assessment between each of 3D/2D, RT3D, TEE planimetry and Cath was 0.81, 0.86 and 0.71, respectively. The intraobserver variability was similar for all methods, but interobserver variability was better for 3D techniques than for TEE (p<0.05). Conclusions: The 3D echo methods for planimetry of the AVA showed good agreement with the standard TEE technique and flow-derived methods. Compared with AV planimetry by TEE, both 3D methods were at least as good as TEE and had better reproducibility. 3D aortic valve planimetry is a novel non-invasive technique, which provides an accurate and reliable quantitative assessment of AS.

AB - Background: Accurate assessment of aortic valve area (AVA) is important for clinical decision-making in patients with aortic valve stenosis (AS). The role of three-dimensional echocardiography (3D) in the quantitative assessment of AS has not been evaluated so far. Objectives: To evaluate the reproducibility and accuracy of real-time three-dimensional echocardiography (RT3D) and 3D-guided two-dimensional planimetry (3D/2D) for assessment of AS, and compare these results with those of standard echocardiography and cardiac catheterisation (Cath). Methods: AVA was estimated by transthoracic echo-Doppler (TTE) and by direct planimetry using transoesophageal echocardiography (TEE) as well as RT3D and 3D/2D. 15 patients underwent assessment of AS by Cath. Results: 33 patients with AS were studied (20 men, mean (SD) age 70 (14) years). Bland-Altman analysis showed good agreement and small absolute differences in AVA between all planimetric methods (RT3D vs 3D/2D: -0.01 (0.15) cm2; 3D/2D vs TEE: 0.05 (0.22) cm2; RT3D vs TEE: 0.06 (0.26) cm2). The agreement between AVA assessment by 2D-TTE and planimetry was -0.01 (0.20) cm2 for 3D/2D; 0.00 (0.15) cm2 for RT3D; and -0.05 (0.30) cm2 for TEE. Correlation coefficient r for AVA assessment between each of 3D/2D, RT3D, TEE planimetry and Cath was 0.81, 0.86 and 0.71, respectively. The intraobserver variability was similar for all methods, but interobserver variability was better for 3D techniques than for TEE (p<0.05). Conclusions: The 3D echo methods for planimetry of the AVA showed good agreement with the standard TEE technique and flow-derived methods. Compared with AV planimetry by TEE, both 3D methods were at least as good as TEE and had better reproducibility. 3D aortic valve planimetry is a novel non-invasive technique, which provides an accurate and reliable quantitative assessment of AS.

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