title: Real-time three-dimensional transoesophageal echocardiography in the assessment of aortic valve stenosis.
abstract: 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.
authors.affiliation: Laboratorio de Ecocardiografía, Servicio de Cardiología, Hospital Universitario Virgen de Arrixaca, Ctra. Murcia-Cartagena S/N, 30120 Murcia, Spain. gdlmorena@yahoo.es
authors.forename: Gonzalo
authors.initials: G
authors.lastname: de la Morena
authors.forename: Daniel
authors.initials: D
authors.lastname: Saura
authors.forename: María J
authors.initials: MJ
authors.lastname: Oliva
authors.forename: Federico
authors.initials: F
authors.lastname: Soria
authors.forename: Josefa
authors.initials: J
authors.lastname: González
authors.forename: Miguel
authors.initials: M
authors.lastname: García
authors.forename: Victoria
authors.initials: V
authors.lastname: Moreno
authors.forename: Juan C
authors.initials: JC
authors.lastname: Bonaque
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés
mesh_terms: 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