Isovolumic contraction time by pulsed-wave Doppler tissue imaging in aortic stenosis.
BACKGROUND
Doppler Tissue Imaging (DTI) has been evaluated in ischaemic heart disease and some cardiomyopathies. In patients with aortic stenosis (AS), left ventricular contraction is slowered. This study aimed to evaluate the possible role of the measurement of isovolumic contraction time (ICT) by DTI in the evaluation of AS severity.


METHODS
The study population constitutes 30 patients: 15 with AS (nine severe and six non-severe) and 15 control subjects. All of them had normal systolic function, sinus rhythm, and absence of ischaemic heart disease of conduction abnormalities. ICT was defined as the time from the onset of the QRS complex to the beginning of the DTI systolic wave. The correlation between ICT and aortic area obtained by continuity equation, as well as the diagnostic value of ICT in the identification of severe AS were studied.


RESULTS
ICT was significantly increased in patients with severe AS (98+/-27 versus 65+/-21 ms, p=0.024). There was a significant correlation between ICT and aortic area (r=-0.56; p=0.035). The receiver operator characteristic curve of ICT in the identification of severe AS yielded an area under the curve of 0.852 (95% confidence interval: 0.665-1.0). The two best cut-points were >73 ms (88% sensitivity, 77% specificity) and >85 ms (78% sensitivity, 83% specificity). A value of >41 ms had a 100% sensitivity, but only a 17% specificity, and >91 ms showed a 100% specificity, but only a 44% sensitivity.


CONCLUSIONS
ICT measured by pulsed-wave DTI is increased in patients with aortic stenosis.
Moreno
R
R
Laboratory of Echocardiography, Hospital Clinico San Carlos, Madrid, Spain. raulmorenog@terra.es
Zamorano
J
J
Almería
C
C
Pérez-González
J A
JA
Mataix
L
L
Rodrigo
J L
JL
Herrera
D
D
Aubele
A
A
Pérez de Isla
L
L
De Marco
E
E
Sánchez-Harguindey
L
L
Macaya
C
C
D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D012680:Sensitivity and Specificity; D013599:Systole; D016277:Ventricular Function, Left