Role of echocardiography in the assessment of aortic stenosis and mitral regurgitation


Authors: L. Koc 1;  T. Zatočil 1;  J. Špinar 1,2
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno 1;  Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně 2
Published in: Kardiol Rev Int Med 2015, 17(2): 136-140
Category: Cardiology Review

Overview

Valvular heart disease represents an important cause of cardiovascular morbidity and mortality. In European countries, aortic stenosis and mitral regurgitation are the most frequent valvular diseases. Echocardiography is the most important method for their quantification. Measurement of the jet velocity across the aortic valve, measurement of the mean transaortic gradient and the assessment of valve area by the continuity equation are standard parameters for the quantification of the aortic stenosis severity. For quantification of mitral regurgitation severity, measurement of vena contracta and the PISA method are used. Assessment of the impact of the valvular disease on the heart chambers is very important as well. In the evaluation of a patient for valvular intervention, echocardiography is one of a number of modalities. It is also important to assess the patient´s symptoms, comorbidities and wishes.

Keywords:
echocardiography – aortic stenosis – mitral regurgitation


Sources

1. Iung B, Vahanian A. Epidemiology of acquired valvular heart dinase. Can J Cardiol 2014; 30: 962– 970. doi: 10.1016/ j.cjca.2014.03.022.

2. Nkomo VT, Gardin JM, Skelton TN et al. Burden of valvular heart diseases: a population‑based study. Lancet 2006; 368: 1005– 1011. doi: 10.1016/ S0140- 6736(06)69208- 8.

3. Eveborn GW, Schirmer H, Heggedlund G et al. The evolving epidemiology of valvular aortic stenosis. The Tromsø Study. Heart 2013; 99: 396– 400. doi: 10.1136/ heartjnl‑ 2012-302265.

4. Ward C. Clinical significance of the bicuspid aortic valve. Heart 2000, 83: 81– 85. doi: 10.1136/ heart.83.1.81.

5. Stamm Ch, Friehs I, Ho SY et al. Congenital supravalvar aortic stenosis: a simple lesion? Eur J Cardiothorac Surg 2001; 19: 195– 202. doi: 10.1016/S1010- 7940(00)00647-3.

6. Etnel JRG, Takkenberg JM, Spaans LG et al. Paediatric subvalvular aortic stenosis: a systematic review and meta‑analysis of natural history and surgical outcome. Eur J Cardiothorac Surg 2014. [online] Available from: http:/ / ejcts.oxfordjournals.org/ content/ early/ 2014/ 11/ 05/ ejcts.ezu423. doi: 10.1093/ ejcts/ ezu423.

7. Baumgartner H, Hung J, Bermejo J et al. Echocardiographic assessment of valve stenosis: EAE/ ASE recommendations for clinical practice.Eur J Echocardiogr 2009, 10: 1– 25. doi: 10.1093/ ejechocard/ jen303.

8. Vahanian A, Alfieri O, Andreotti F et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012; 33: 2451– 2496. doi: 10.1093/ eurheartj/ ehs109.

9. Currie PJ, Seward JB, Reeder GS et al. Continuous‑ wave Doppler echocardiographic assess­ment of severity of calcific aortic stenosis: a simultaneous Doppler‑ catheter correlative study in 100 adult patients. Circulation 1985; 71: 1162– 1169. doi: 10.1161/ 01.CIR.71.6.1162.

10. Kizilbash AM, Heinle SK a Grayburn PA. Spontaneous variability of left ventricular outflow tract gradient in hypertrophic obstructive cardiomyopathy. Circulation 1998; 97: 461– 466. doi: 10.1161/ 01.CIR.97.5.461.

11. Hattle LB, Angelsen A, Tromsdal A. Non‑ invasive assessment of aortic stenosis by Doppler ultrasound. Br Heart J 1980; 43: 284– 292. doi: 10.1136/ hrt.43.3.284.

12. Oh JK, Taliercio CP, Holmes DR et al. Prediction of the severity of aortic stenosis by Doppler aortic valve area determination: prospective Doppler‑ catheterization correlation in 100 patients. J Am Coll Cardiol 1988; 11: 1227– 1234.

13. Skjaerpe T, Hegrenaes L, Hatle T. Noninvasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two‑dimensional echocardiography. Circulation 1985; 72: 810– 818. doi: 10.1161/ 01.CIR.72.4.810.

14. Yiu SF, Enriquez‑ Sarano M, Tribouilloy Ch et al. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction A quantitative clinical study. Circulation 2000; 102: 1400– 1406. doi: 10.1161/ 01.CIR.102.12.1400.

15. Chaliki HP, Nishimura RA, Enriquez‑ Sarano M et al. A simplified, practical approach to assessment of severity of mitral regurgitation by Doppler color flow imaging with proximal convergence: validation with concomitant cardiac catheterization. Mayo Clin Proc 1998; 73: 929– 935. doi: 10.4065/ 73.10.929.

16. Heinle SK, Hall SA, Brickner ME et al. Comparison of vena contracta width by multiplane trans­esophageal echocardiography with quantitative doppler assessment of mitral regurgitation. Am J Cardiol 1998; 81: 175– 179. doi: 10.1016/ S0002- 9149(97)00878- 3.

17. Lancellotti P, Moura L, Pierard LA et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr 2010; 11: 307– 332. doi: 10.1093/ ejechocard/ jeq031.

18. Enriquez‑ Saran M, Miller FA, Hayes SN et al. Effective mitral regurgitant orifice area: clinical use and pitfalls of the proximal isovelocity surface area method. J Am Coll Cardiol 1995; 25: 703– 709. doi: 10.1016/ 0735- 1097(94)00434- R.

19. Enriquez‑ Sarano M, Avierinos JF, Messika‑ Zeitoun D et al. Quantitative determinants of the outcome of asymp­tomatic mitral regurgitation. N Engl J Med 2005; 352: 875– 883. doi: 10.1056/ NEJMoa041451.

20. Iwakura K, Ito H, Kawano S et al. Comparison of Orifice Area by Transthoracic Three‑ Dimensional Doppler Echocardiography Versus Proximal Isovelocity Surface Area (PISA) Method for Assessment of Mitral Regurgitation. Am J Cardiol 2006; 97: 1630– 1637. doi: 10.1016/ j.amjcard.2005.12.065.

21. Omran AS, Woo A, David TE et al. Intraoperative transesophageal echocardiography accurately predicts mitral valve anatomy and suitability for repair. J Am Soc Echocardiogr 2002; 15: 950– 957. doi: 10.1067/ mje.2002.121534.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

×