Comparative analysis of echocardiographic indicators of acceleration time and the ratio of acceleration time to total left ventricular ejection time with catheterization indicators in assessing the severity of aortic stenosis in patients with Normal flow High Gradient

Abstract

Purpose . 1. To compare the ultrasound indices of time in comparison (AT), cardiac catheterization evaluating severity (AT/ET) with the indices of direct cardiac catheterization and assess the prognostic ability in the assessment of severity of AS in patients with Normal flow High Gradient 2. To determine the threshold values for the indicators of AT and AT/ET in predicting severe AS. Materials and methods . This is prospective single center study. We evaluated results of treatment of 75 patients with mean age 72 ± 6 years that were planned for aortic valve replacement due to aortic stenosis. Inclusion criteria: isolated aortic valve stenosis with ultrasound characteristics of severe AS. Before transcatheter aortic valve implantation, all patients underwent cardiac catheterization with the measurement of parameters necessary to assess the severity of AS. Results . Linear regression analysis showed a statistically significant correlation between AT and AT/ET (p < 0.05). The ROC-analysis has showed the highest predictive ability in assessing the severity of aortic stenosis for the AT / ET index (AUC – 87%, p < 0.001), slightly lower predictive power for the AT parameter (AUC – 80%, p < 0.001). The sensitivity and specificity of the AT / ET indicator in determining severe AS was 84% and 79%, respectively. For the AT indicator, the sensitivity was 82% and the specificity was 46%. The threshold values for AT and AT / ET were 105 ms and 0.35, respectively. Conclusions . 1. AT and AT / ET have a strong correlation with catheterization data and a high predictive ability of severe aortic stenosis in patients with Normal Flow High Gradient patients. 2. Threshold values for AT and AT /ET, that predict a high probability of AS, were 105ms and 0.35ms respectively. The study showed, echocardiographic indicators AT and AT ET have a strong correlation with catheterization data and a high predictive ability of severe aortic stenosis in patients with Normal Flow High Gradient patients. Threshold values for AT and AT ET, that predict a high probability of AS, were 105 ms and 0.35 ms respectively.