Aortic valve type and calcification as assessed by transthoracic and transoesophageal echocardiography

作者：Yousry Mohamed; Rickenlund Anette; Petrini Johan; Jenner Jonas; Liska Jan; Eriksson Per; Franco Cereceda Anders; Eriksson Maria J; Caidahl Kenneth^*

来源：Clinical Physiology and Functional Imaging, 2015, 35(4): 306-313.

DOI：10.1111/cpf.12166

• bicuspid
• grey scale
• scoring
• tricuspid
• ultrasound

IntroductionAortic valve calcification (AVC) may predict poor outcome. Bicuspid aortic valve (BAV) leads to several haemodynamic changes accelerating the progress of aortic valve (AV) disease.
AimsTo compare the diagnostic accuracy of transoesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) in the assessment of aortic valve phenotype and degree of AVC, with intra-operative evaluation as a reference.
MethodsWe examined 169 patients (median age 65years, 51 women) without significant coronary artery disease undergoing AV and/or aortic root surgery. TTE was performed within a week prior to surgery and TEE at the time of surgery.
ResultsCompared with surgical AVC assessment, visual evaluation using a 5-grade scoring system and real-time images showed a higher correlation (TTEr=083 and TEEr=082) than visual (TTEr=064 and TEE 063) or grey scale mean (GSMn) (TTEr=063 and TEEr=052) assessment of end-diastolic still frames. AVC assessment using real-time images showed high intraclass correlation coefficients (TTE 094 and TEE 093). With regard to BAV, TEE was superior to TTE with a higher interobserver agreement, sensitivity and specificity (086, 92% and 94% versus 057, 77% and 82%, respectively).
ConclusionSemi-quantitative AVC assessment of real-time cine loops from both TEE and TTE correlated well with intra-operative evaluation of AVC. Applying a predefined scoring system for AVC evaluation assures a high interobserver correlation. TEE was superior to TTE for evaluation of valve phenotype and should be considered when a diagnosis of BAV is clinically important.

• 出版日期2015-7