Desai Kevin, Slostad Brody, Twing Aamir, Krishna Hema, Frazin Leon, Kansal Mayank
Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
Department of Cardiology, University of Illinois at Chicago, Chicago, Illinois.
J Am Soc Echocardiogr. 2023 Jan;36(1):69-76. doi: 10.1016/j.echo.2022.10.023. Epub 2022 Nov 5.
Aortic valve (AV) calcification (AVC) is a strong predictor of aortic stenosis (AS) severity. The two-dimensional AVC (2D-AVC) ratio, a gain-independent ratio composed of the average pixel density of the AV and the aortic annulus, has previously shown strong correlations with two-dimensional (2D) echocardiographic hemodynamic parameters for severe AS and AVC by cardiac computed tomography. We hypothesize that the 2D-AVC ratio correlates with hemodynamic parameters in all severities of AS.
A total of 285 patients with a normal AV (n = 49), aortic sclerosis (n = 75), or mild (n = 38), moderate (n = 72), or severe (n = 51) AS undergoing 2D echocardiography were retrospectively evaluated, and the 2D-AVC ratios were correlated to mean AV gradient, peak AV velocity, AV area, and dimensionless index. The 2D-AVC ratios of various AS severities were compared against each other via area under the curve (AUC) analysis.
The 2D-AVC ratio is strongly correlated with mean AV gradient (r = 0.79, P < .0001) and peak AV velocity (r = 0.78, P < .0001). There was moderate correlation with the AV area (r = -0.58, P < .0001) and dimensionless index (r = -0.67, P < .0001) across all AS severities. The 2D-AVC ratio also distinguished nonmoderate AS (mild AS + normal AV) from moderate or greater (moderate + severe) AS (AUC = 0.93) and moderate versus severe AS (AUC = 0.88).
The 2D-AVC ratio exhibits moderate to strong correlation with 2D echocardiographic hemodynamic parameters across all severities of AS.
主动脉瓣钙化（AVC）是主动脉瓣狭窄（AS）严重程度的有力预测指标。二维AVC（2D-AVC）比值是一种与增益无关的比值，由主动脉瓣和主动脉瓣环的平均像素密度组成，此前已显示其与通过心脏计算机断层扫描得出的重度AS和AVC的二维（2D）超声心动图血流动力学参数密切相关。我们假设2D-AVC比值与所有严重程度的AS的血流动力学参数相关。
对285例接受二维超声心动图检查的患者进行回顾性评估，这些患者分别患有正常主动脉瓣（n = 49）、主动脉硬化（n = 75）或轻度（n = 38）、中度（n = 72）或重度（n = 51）AS，将2D-AVC比值与平均主动脉瓣压差、主动脉瓣峰值流速、主动脉瓣面积和无量纲指数进行相关性分析。通过曲线下面积（AUC）分析比较不同AS严重程度的2D-AVC比值。
2D-AVC比值与平均主动脉瓣压差（r = 0.79，P <.0001）和主动脉瓣峰值流速（r = 0.78，P <.0001）密切相关。在所有AS严重程度中，与主动脉瓣面积（r = -0.58，P <.0001）和无量纲指数（r = -0.67，P <.0001）存在中度相关性。2D-AVC比值还可区分非中度AS（轻度AS + 正常主动脉瓣）与中度或更重度AS（中度 + 重度）（AUC = 0.93）以及中度与重度AS（AUC = 0.88）。
2D-AVC比值在所有AS严重程度中均与二维超声心动图血流动力学参数呈现中度至高度相关性。
