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Impact of Energy Loss Index and Valvuloarterial Impedance in Patients with Aortic Stenosis Using Three‐Dimensional Echocardiography
Author(s) -
Saitoh Takeji,
Tanaka Jun,
Furugen Azusa,
Harada Kenji,
Izumo Masaki,
Fukuoka Yoko,
Shiota Takahiro
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12705
Subject(s) - medicine , cardiology , ventricular outflow tract , stenosis , body surface area , nuclear medicine
Background Energy loss index ( ELI ) and valvuloarterial impedance (Z va ) have been evaluated with a lack of three‐dimensional (3D) information regarding the left ventricular outflow tract ( LVOT ) and sino‐tubular junction ( STJ ). Our aim of this study is to compare the difference of ELI and Z va between two‐dimensional (2D) and 3D echocardiography. Methods In 74 patients with moderate‐to‐severe aortic stenosis, the effective orifice area index (EOAI: EOA/body surface area) was calculated by continuity equation based on both 2D transthoracic echocardiography (2DTTE) and 3D transesophageal echocardiography (3DTEE). The areas of the LVOT and the STJ were calculated with the assumption of π × (dimension/2) 2 by 2DTTE and were measured directly by 3DTEE. Severe AS was defined as EOAI or ELI <0.6 cm 2 /m 2 or Z va ≥ 4.5 mmHg/mL per m 2 . Results Both the LVOT and STJ were elliptical, and LVOT was more elliptical than STJ. The ELI by 3DTEE (0.58 cm 2 /m 2 [median]) was larger than the other 3 values: EOAI on 2DTTE = 0.41, P < 0.01; EOAI on 3DTEE = 0.49, P < 0.01; and ELI on 2DTTE = 0.49, P < 0.01. Furthermore, Z va by 2DTTE, 4.7 mmHg/mL per m 2 , was larger than that by 3DTEE (3.8, P < 0.01). Conclusions 2DTTE underestimated EOAI and ELI relative to 3DTEE and overestimated Z va relative to 3DTEE.