Validation of the severity index by cardiac catheterization and Doppler echocardiography in patients with aortic sclerosis and stenosis.
The severity index is a new echocardiographic measure that is thought to be an accurate indicator of aortic leaflet pathology in patients with AS. However, it has not been validated against cardiac catheterization or Doppler echocardiographic measures of AS severity nor has it been applied to patients with aortic sclerosis. The purposes of this study were to compare the severity index to invasive hemodynamics and Doppler echocardiography across the spectrum of calcific aortic valve disease, including aortic sclerosis and AS. 48 patients with aortic sclerosis and AS undergoing echocardiography and cardiac catheterization comprised the study population. The aortic valve leaflets were assessed for mobility (scale 1 to 6) and calcification (scale 1 to 4) and the severity index was calculated as the sum of the mobility and calcification scores according to the methods of Bahler et al. The severity index increased with increasing severity of aortic valve disease; the severity indices for patients with aortic sclerosis, mild to moderate AS and severe AS were 3.38 +/- 1.06, 6.45 +/- 2.16 and 8.38 +/- 1.41, respectively. The aortic jet velocity by echocardiography and the square root of the maximum aortic valve gradient by cardiac catheterization correlated well with the severity index (r = 0.84, p < 0.0001; r = 0.84, p < 0.0001, respectively). These results confirm that the severity index correlates with hemodynamic severity of aortic valve disease and may prove to be a useful measure in patients with aortic sclerosis and AS.
Los Angeles BioMedical Research Institute at Harbor-UCLA Research, Division of Cardiology, Torrance, CA, USA. dshavelle@hotmail.com
David M
DM
Shavelle
Nediljka
N
Buljabasic
Junichiro
J
Takasu
Ashkan
A
Babaie
Joseph
J
Rosales
Matthew J
MJ
Budoff
Kevin D
KD
O'Brien
D001022:Aortic Valve Insufficiency / Q000175:diagnosis*; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D001795:Blood Pressure Determination / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012598:Sclerosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index