Coexisting cardiac diseases and pressure recovery phenomenon contribute to discrepancy between the echocardiographic severity of aortic stenosis and left ventricular hypertrophy

Ayumu Abe, Taisei Mikami, Sanae Kaga, Kanako Tsuji, Kazunori Okada, Shinobu Yokoyama, Hisao Nishino, Masahiro Nakabachi, Mutsumi Nishida, Chikara Shimizu, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Assessing left ventricular (LV) hypertrophy (LVH) is an important step in the echocardiographic diagnosis of aortic stenosis (AS). We aimed to investigate the causes of discrepancies between the degrees of AS and LVH. Methods: The study subjects consisted of 149 consecutive patients with AS having aortic valve area <2.0 cm2 (mean age 72.5 ± 11.9 years, 67 men and 82 women). Coexisting cardiac diseases were determined based on echocardiographic findings and comprehensive clinical judgment. Echocardiographic measurements included LV mass index (LVMI), aortic valve area index (AVAI), transaortic mean pressure gradient (MPG), valvulo-arterial impedance (Zva), energy loss coefficient (ELCo), and energy loss index (ELI). Results: LVMI was not significantly correlated with AVAI and Zva, and had a weak correlation with MPG (r = 0.305, p = 0.0001). There were 55 patients in group A (non-severe AS without significant LVH), 58 in group B (non-severe AS with significant LVH), 7 in group C (severe AS without significant LVH), and 29 in group D (severe AS with significant LVH). Coexisting cardiac diseases were more frequently observed (p = 0.0003) in group B (50 %) than in group A (18 %). In group C, ELCo and (ELI - AVAI)/ELI were significantly greater than in group D (p = 0.043 and 0.007, respectively). Conclusion: Significant LVH seen in less than moderate AS is often due to coexisting cardiac diseases, and there may be an overestimation of AS severity due to pressure recovery among patients with apparently severe AS who do not have significant LVH.

Original languageEnglish
Pages (from-to)41-49
Number of pages9
JournalJournal of Echocardiography
Volume11
Issue number2
DOIs
Publication statusPublished - Jun 1 2013
Externally publishedYes

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Aortic Valve Stenosis
Left Ventricular Hypertrophy
Heart Diseases
Pressure
Hypertrophy
Aortic Valve
Electric Impedance

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Coexisting cardiac diseases and pressure recovery phenomenon contribute to discrepancy between the echocardiographic severity of aortic stenosis and left ventricular hypertrophy. / Abe, Ayumu; Mikami, Taisei; Kaga, Sanae; Tsuji, Kanako; Okada, Kazunori; Yokoyama, Shinobu; Nishino, Hisao; Nakabachi, Masahiro; Nishida, Mutsumi; Shimizu, Chikara; Iwano, Hiroyuki; Yamada, Satoshi; Tsutsui, Hiroyuki.

In: Journal of Echocardiography, Vol. 11, No. 2, 01.06.2013, p. 41-49.

Research output: Contribution to journalArticle

Abe, Ayumu ; Mikami, Taisei ; Kaga, Sanae ; Tsuji, Kanako ; Okada, Kazunori ; Yokoyama, Shinobu ; Nishino, Hisao ; Nakabachi, Masahiro ; Nishida, Mutsumi ; Shimizu, Chikara ; Iwano, Hiroyuki ; Yamada, Satoshi ; Tsutsui, Hiroyuki. / Coexisting cardiac diseases and pressure recovery phenomenon contribute to discrepancy between the echocardiographic severity of aortic stenosis and left ventricular hypertrophy. In: Journal of Echocardiography. 2013 ; Vol. 11, No. 2. pp. 41-49.
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T1 - Coexisting cardiac diseases and pressure recovery phenomenon contribute to discrepancy between the echocardiographic severity of aortic stenosis and left ventricular hypertrophy

AU - Abe, Ayumu

AU - Mikami, Taisei

AU - Kaga, Sanae

AU - Tsuji, Kanako

AU - Okada, Kazunori

AU - Yokoyama, Shinobu

AU - Nishino, Hisao

AU - Nakabachi, Masahiro

AU - Nishida, Mutsumi

AU - Shimizu, Chikara

AU - Iwano, Hiroyuki

AU - Yamada, Satoshi

AU - Tsutsui, Hiroyuki

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Background: Assessing left ventricular (LV) hypertrophy (LVH) is an important step in the echocardiographic diagnosis of aortic stenosis (AS). We aimed to investigate the causes of discrepancies between the degrees of AS and LVH. Methods: The study subjects consisted of 149 consecutive patients with AS having aortic valve area <2.0 cm2 (mean age 72.5 ± 11.9 years, 67 men and 82 women). Coexisting cardiac diseases were determined based on echocardiographic findings and comprehensive clinical judgment. Echocardiographic measurements included LV mass index (LVMI), aortic valve area index (AVAI), transaortic mean pressure gradient (MPG), valvulo-arterial impedance (Zva), energy loss coefficient (ELCo), and energy loss index (ELI). Results: LVMI was not significantly correlated with AVAI and Zva, and had a weak correlation with MPG (r = 0.305, p = 0.0001). There were 55 patients in group A (non-severe AS without significant LVH), 58 in group B (non-severe AS with significant LVH), 7 in group C (severe AS without significant LVH), and 29 in group D (severe AS with significant LVH). Coexisting cardiac diseases were more frequently observed (p = 0.0003) in group B (50 %) than in group A (18 %). In group C, ELCo and (ELI - AVAI)/ELI were significantly greater than in group D (p = 0.043 and 0.007, respectively). Conclusion: Significant LVH seen in less than moderate AS is often due to coexisting cardiac diseases, and there may be an overestimation of AS severity due to pressure recovery among patients with apparently severe AS who do not have significant LVH.

AB - Background: Assessing left ventricular (LV) hypertrophy (LVH) is an important step in the echocardiographic diagnosis of aortic stenosis (AS). We aimed to investigate the causes of discrepancies between the degrees of AS and LVH. Methods: The study subjects consisted of 149 consecutive patients with AS having aortic valve area <2.0 cm2 (mean age 72.5 ± 11.9 years, 67 men and 82 women). Coexisting cardiac diseases were determined based on echocardiographic findings and comprehensive clinical judgment. Echocardiographic measurements included LV mass index (LVMI), aortic valve area index (AVAI), transaortic mean pressure gradient (MPG), valvulo-arterial impedance (Zva), energy loss coefficient (ELCo), and energy loss index (ELI). Results: LVMI was not significantly correlated with AVAI and Zva, and had a weak correlation with MPG (r = 0.305, p = 0.0001). There were 55 patients in group A (non-severe AS without significant LVH), 58 in group B (non-severe AS with significant LVH), 7 in group C (severe AS without significant LVH), and 29 in group D (severe AS with significant LVH). Coexisting cardiac diseases were more frequently observed (p = 0.0003) in group B (50 %) than in group A (18 %). In group C, ELCo and (ELI - AVAI)/ELI were significantly greater than in group D (p = 0.043 and 0.007, respectively). Conclusion: Significant LVH seen in less than moderate AS is often due to coexisting cardiac diseases, and there may be an overestimation of AS severity due to pressure recovery among patients with apparently severe AS who do not have significant LVH.

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U2 - 10.1007/s12574-012-0161-x

DO - 10.1007/s12574-012-0161-x

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