Real-time three-dimensional transoesophageal echocardiography in the assessment of aortic valve stenosis.
OBJECTIVE
To determine the feasibility of real-time three-dimensional transoesophageal echocardiography (3D-TOE) in the evaluation of aortic valve stenosis, to study its reliability, and to test the concordance of this new method when compared with transthoracic two-dimensional echocardiography (2D-TTE) as the diagnostic standard.


RESULTS
Fifty-nine consecutive patients with moderate-to-severe aortic valve stenosis were assessed by means of 2D-TTE and 3D-TOE by independent blinded observers. Aortic valve planimetry was possible in 94.9% of patients. Inter-observer intraclass correlation coefficients (ICC) were 0.892 (CI 95% 0.818-0.936; P < 0.001), and 0.871 (CI 95% 0.780-0.925; P < 0.001) for 2D-TTE and 3D-TOE, respectively. Bland-Altman plot showed a mean difference in aortic valve area (AVA) of 0.040 cm(2), with 2D-TTE yielding larger values than 3D-TOE. ICC of both methods was 0.724 (CI 95% 0.530-0.839; P < 0.001).


CONCLUSIONS
Assessment of AVA by means of 3D-TOE is feasible in most patients with aortic valve stenosis. Reliability of the measurement is good. However, there is some disagreement with standard 2D-TTE that needs further investigation.
de la Morena
Gonzalo
G
Laboratorio de Ecocardiografía, Servicio de Cardiología, Hospital Universitario Virgen de Arrixaca, Ctra. Murcia-Cartagena S/N, 30120 Murcia, Spain. gdlmorena@yahoo.es
Saura
Daniel
D
Oliva
María J
MJ
Soria
Federico
F
González
Josefa
J
García
Miguel
M
Moreno
Victoria
V
Bonaque
Juan C
JC
Valdés
Mariano
M
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D016001:Confidence Intervals; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic