Diagnostic accuracy of continuous wave doppler echocardiography in severe aortic stenosis in the elderly.

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Forty-four male patients (mean age 63.6 years) with aortic stenosis (AS) were evaluated by conventional hemodynamic methods and continuous wave (CW) Doppler echocardiography. The relationship between Doppler mean gradients and direct mean pressure gradients in all patients was significant, with an r value of 0.88. Sixteen of 17 patients with a mean Doppler gradient ≥40mmHg had severe AS (AVA≤1.0 cm2). Twenty-seven patients had a Doppler gradient <40mmHg, and 8 of these patients had severe AS (AVA ≤1.0cm2). The sensitivity and specificity of a Doppler gradient ≥40mmHg in detecting severe AS were, therefore, 67% and 95%, respectively. Thirty-three percent (8/24) of patients with severe AS and low Doppler gradients (<40mmHg) had evidence of poor left ventricular function, evidenced by a lower cardiac output, a higher heart rate and an abnormal PEP/LVET ratio compared to the other patients. Thus, the presence of a low stroke volume ≤60ml/ beat and PEP/LVET×HR >26 is of value in identifying patients where the Doppler is likely to significantly underestimate the degree of aortic stenosis.
International Heart Journal刊行会の論文