[M-mode echocardiography determination of the severity of aortic stenosis: is the assumption of constant wall stress a realistic approach?].

We reevaluated a previously described M-mode echocardiographic method for the assessment of the hemodynamic severity of an isolated or predominant, advanced aortic stenosis in 89 adult patients without significant associated coronary artery disease. Endsystolic left ventricular wall thickness and diameters were measured using the echocardiogram and left ventricular systolic pressure was calculated under the assumption of a constant left ventricular wall stress (235 mm Hg); the results were compared with the pressure values measured during catheterization. The correlation between the echocardiographic and the invasively determined pressure values was poor and without any clinical relevance; r-values ranged between 0.14 and 0.46. Calculated left ventricular wall stress showed a large scatter with values between 126 mm Hg and 468 mm Hg. Our data indicate that in adults with aortic stenosis, M-mode echocardiographic determination of the hemodynamic severity is not possible, and the assumption of a constant left ventricular wall stress in these patients is misleading.