Scholarlink

Objectives <p>Transthoracic echocardiography (TTE) is the standard modality for grading aortic stenosis (AS) severity. Transesophageal echocardiography (TOE) allows direct aortic valve area (AVA) planimetry (AVA<sub>TOE</sub>), while computed tomography angiography (CTA) offers a non-invasive alternative (AVA<sub>CTA</sub>). This study aimed to evaluate the correlation between AVA measurements across modalities and to determine a diagnostic AVA<sub>CTA</sub> threshold for severe AS.</p> Methods <p>This retrospective study included a single-center derivation cohort of 176 patients (mean age 80.0 ± 7.7 years, 52.8% male) with moderate to severe AS who underwent full-cycle CTA, TTE, and TOE. AVA<sub>CTA</sub> was measured by two independent raters. Correlation with AVA<sub>TOE</sub> and other parameters was assessed. Receiver operating characteristic (ROC) analysis was used to define an optimal AVA<sub>CTA</sub> threshold for severe AS, which was validated in a multi-center cohort of 407 patients (mean age 80.9 ± 6.7 years, 52.8% male) with comparable characteristics.</p> Results <p>Mean AVA<sub>CTA</sub> was 0.96 ± 0.28&#xa0;cm² with a high interrater reliability (IRR = 0.84), compared to a mean AVA<sub>TOE</sub> of 0.88 ± 0.26&#xa0;cm² (Pearson’s <i>r</i> = 0.73). ROC analysis identified 0.96&#xa0;cm² as the optimal AVA<sub>CTA</sub> threshold for diagnosing severe AS (AUC = 0.846; sensitivity = 71.7%; specificity = 89.8%) compared to TOE grading. This threshold yielded good diagnostic performance in the validation cohort (AUC = 0.817; sensitivity = 78.2%; specificity = 72.6%).</p> Conclusions <p>AVA<sub>CTA</sub> demonstrated high reliability, showing a strong correlation with AVA<sub>TOE</sub>. The 0.96&#xa0;cm² threshold, defined in the derivation cohort, performed well in the validation cohort for assessing aortic stenosis severity.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Multimodality assessment of aortic valve area in aortic stenosis: a multicenter validation study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月1日

查看全文
  • Christian Weber,
  • J. Studier-Fischer,
  • H. Reiss,
  • S. von Garlen,
  • S. Piepenburg,
  • C. Ehlert,
  • A. Maier,
  • S. Vögele,
  • M. Hein,
  • P. Ruile,
  • J. Fingerhut,
  • S. Jäck,
  • M. T. Hagar,
  • J. Taron,
  • C. Schlett,
  • M. Potratz,
  • T. Rudolph,
  • J. Steffen,
  • D. Hering,
  • S. Deseive,
  • S. Massberg,
  • A. Schwab,
  • J. Leberzammer,
  • P. C. Seppelt,
  • J. Rilinger,
  • M. Zehender,
  • I. Hilgendorf,
  • D. Westermann,
  • C. von zur Mühlen,
  • T. Heidt

摘要

Objectives

Transthoracic echocardiography (TTE) is the standard modality for grading aortic stenosis (AS) severity. Transesophageal echocardiography (TOE) allows direct aortic valve area (AVA) planimetry (AVATOE), while computed tomography angiography (CTA) offers a non-invasive alternative (AVACTA). This study aimed to evaluate the correlation between AVA measurements across modalities and to determine a diagnostic AVACTA threshold for severe AS.

Methods

This retrospective study included a single-center derivation cohort of 176 patients (mean age 80.0 ± 7.7 years, 52.8% male) with moderate to severe AS who underwent full-cycle CTA, TTE, and TOE. AVACTA was measured by two independent raters. Correlation with AVATOE and other parameters was assessed. Receiver operating characteristic (ROC) analysis was used to define an optimal AVACTA threshold for severe AS, which was validated in a multi-center cohort of 407 patients (mean age 80.9 ± 6.7 years, 52.8% male) with comparable characteristics.

Results

Mean AVACTA was 0.96 ± 0.28 cm² with a high interrater reliability (IRR = 0.84), compared to a mean AVATOE of 0.88 ± 0.26 cm² (Pearson’s r = 0.73). ROC analysis identified 0.96 cm² as the optimal AVACTA threshold for diagnosing severe AS (AUC = 0.846; sensitivity = 71.7%; specificity = 89.8%) compared to TOE grading. This threshold yielded good diagnostic performance in the validation cohort (AUC = 0.817; sensitivity = 78.2%; specificity = 72.6%).

Conclusions

AVACTA demonstrated high reliability, showing a strong correlation with AVATOE. The 0.96 cm² threshold, defined in the derivation cohort, performed well in the validation cohort for assessing aortic stenosis severity.