Abstract
Accurate noninvasive evaluation of patients with valvar aortic stenosis (AS) would improve selection for catheterization. 29 children with AS, ages 2 to 16 years, were evaluated by cardiac catheterization and echocardiography. No patient had congestive heart failure or more than trace aortic insufficiency. Left ventricular to aortic pressure difference (LV-Ao) was estimated by: LV-Ao=13×(murmur score)+RV6(mm.)−6×QV6(mm.)−9. Resting LV and Ao pressures were measured and aortic valve area (AVA/m2) was calculated. The systolic left ventricular posterior wall thickness (LVPW) and internal diameter (LVID) were measured on the echocardiograms without knowledge of catheterization findings. A predicted LV-Ao <30 mmHg, estimated from murmurs and electrocardiogram, would have allowed us to avoid catheterization in only 4 of the 29 patients. Comparison of predicted and measured LV-Ao yielded an r value of 0.58. The LVPW/LVID ratio was compared to LV peak systolic pressure, measured LV-Ao and AVA/m2. Linear regression analysis yielded r values of 0.81, 0.84, and 0.74 respectively. The mean (range) and number of patients for LV-Ao and AVA/m2 at different LVPW/LVID were:
The 10 patients with LVPW/LVID ≥0.55 had mild stenosis, not requiring catheterization.
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Bass, J., Einzig, S., Hong, C. et al. 83 ECHOCARDIOGRAPHY ASSESSMENT OF VALVAR AORTIC STENOSIS. Pediatr Res 12 (Suppl 4), 377 (1978). https://doi.org/10.1203/00006450-197804001-00088
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DOI: https://doi.org/10.1203/00006450-197804001-00088