Usefulness of noninvasive assessment of aortic stenosis before and after percutaneous aortic valvuloplasty.

Noninvasive and catheterization studies were performed in 40 patients (mean age 76 +/- 12 years) before and after percutaneous aortic valvuloplasty. Measurements included time to 1/2 carotid upstroke, left ventricular ejection time, aortic valve excursion, mean aortic valve gradient and aortic valve area assessed using the continuity equation: aortic valve area = A X V/V1, where A = left ventricular outflow tract area, V = maximal left ventricular outflow tract velocity assessed by pulsed Doppler echocardiography and V1 = peak velocity in the aortic stenotic jet assessed using continuous-wave echocardiography. In addition, mitral regurgitation was assessed by pulsed Doppler mapping techniques. Mean aortic valve gradient, cardiac output and aortic valve area, calculated using the Gorlin formula, were determined at cardiac catheterization. There were significant correlations between Doppler and catheterization measurements of aortic valve area both before (r = 0.71, p less than 0.001) and after (r = 0.85, p less than 0.0001) valvuloplasty. The relations were demonstrated to be linear by F test and met criteria for identity. There were significant increases (all p less than 0.0005) after valvuloplasty in catheterization valve area (0.60 +/- 0.21 to 0.95 +/- 0.39 cm2), Doppler valve area (0.64 +/- 0.22 to 0.91 +/- 0.37 cm2), valve excursion (0.5 +/- 0.3 to 0.8 +/- 0.3 cm) and cardiac output (4.5 +/- 1.6 to 4.9 +/- 1.7 liter/min).(ABSTRACT TRUNCATED AT 250 WORDS)