Resumo

TAMAYO ARTUNDUAGA, Natalia et al. Echocardiographic evaluation of aortic stenosis severity and inconsistencies amongst diagnostic criteria. Rev. Colomb. Cardiol. [online]. 2016, vol.23, n.3, pp.181-190. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2015.12.005.

We explore inconsistencies of doppler parametres and aortic valve area in patient groups with a small, average and large aortic ring. Methods: Retrospective, cross-sectional analysis of echocardiograms between 2010 and 2014 in patients with aortic stenosis, ejection fraction ≥ 50%, average gradient ≥ 20 mmHg and aortic valve area ≤ 1.5 cm², were divided into three groups: small aortic ring 1.3-1.8 cm, average aortic ring 1.9-2.2 cm and large aortic ring, larger than 2.3 cm. Results: Out of 245 patients, 47% of whom were men, presented the aortic valve area (AVA) continuity 0.84 ± 0.29 cm² and the average gradient was 34.8 mmHg. Paradoxical low-flow, low-gradient aortic stenosis was present in 11.8% of the cases. Strongest correlation was found between the aortic ring and the size. AVA cut point of 1 cm² was consistent for patients with an average and large aortic ring. Doppler index was the parametres with the highest correlation with AVA in all groups. The AVA indexing according to the body surface and not the size did not improve discrepancies for patients with small aortic rings. Conclusions: Parametres that assess the degree of severity of aortic stenosis based on current guidelines are consistent for patients with a large and average aortic ring. Aortic stenosis cut point varies and depends on the aortic ring; a review of the guidelines of the cut points for patients with a small aortic ring should be considered.

Palavras-chave : Aortic stenosis; Echocardiogram; Diagnosis.

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