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Real‐time imaging required for optimal echocardiographic assessment of aortic valve calcification
Author(s) -
Yousry Mohamed,
Rickenlund Anette,
Petrini Johan,
Gustavsson Tomas,
Prahl Ulrica,
Liska Jan,
Eriksson Per,
FrancoCereceda Anders,
Eriksson Maria J,
Caidahl Kenneth
Publication year - 2012
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2012.01153.x
Subject(s) - medicine , calcification , intraclass correlation , aortic valve , regurgitation (circulation) , cardiology , stenosis , ascending aorta , aorta , aortic valve stenosis , radiology , clinical psychology , psychometrics
Summary Introduction Aortic valve calcification ( AVC ), even without haemodynamic significance, may be prognostically import as an expression of generalized atherosclerosis, but techniques for echocardiographic assessment are essentially unexplored. Methods Two‐dimensional (2 D ) echocardiographic recordings ( P hilips IE 33) of the aortic valve in short‐axis and long‐axis views were performed in 185 consecutive patients within 1 week before surgery for aortic stenosis ( n = 109, AS ), aortic regurgitation ( n = 61, AR ), their combination ( n = 8) or dilation of the ascending aorta ( n = 7). The grey scale mean ( GSM n) of the aortic valve in an end‐diastolic short‐axis still frame was measured. The same frame was scored visually 1–5 as indicating that the aortic valve was normal, thick, or had mild, moderate or severe calcification. The visual echodensity of each leaflet was determined real time applying the same 5‐grade scoring system for each leaflet, and the average for the whole valve was calculated. Finally, a similar calcification score for the whole valve based on inspection and palpation by the surgeon was noted. Results Visual assessment of real‐time images using the proposed scoring system showed better correlation with the surgical evaluation of the degree of valve calcification ( r = 0·83, P <0·001) compared to evaluation of stop frames by visual assessment ( r = 0·66, P <0·001) or the GSM n score ( r = 0·64, P <0·001). High inter‐ and intra‐observer correlations were observed for real‐time visual score (both intraclass correlation coefficient = 0·93). Conclusion Real‐time evaluation of the level of AVC is superior to using stop frames assessed either visually or by dedicated computer grey scale measurement software.