Abstract
Background: Measurements of peak jet velocity and systolic gradients (PSG) in aortic stenosis (AS) are used in the continuity equation to calculate as well as clinically to classify severity. In 1985, Rozenman and Gotsman demonstrated preservation of the inverse linear relationship between left ventricular ejection time and heart rate (HR) and that the PSG across a stenosis, assuming normal cardiac output, is HR dependent, especially in bradyor tachycardia. We sought to evaluate the potential diagnostic importance ofHR correction in the evaluation of AS severity. Methods: Retrospective database interrogation between 2007 and 2014 detected 93 patients with severe native AS by current guidelines (PSG > 64mmHg) and 103 patients with moderate AS (PSG 36 63mmHg). HRwas determined using semi-quantitative software calculating the aortic R-R interval. Results: In patients with severe AS and HR 70/min (n=39), PSG increased by 11 +/9 [6 to 32] mmHg and 44% were reclassified to severe AS. Conclusion: Using the Rozenman formula, this is the first study to demonstrate the importance of HR correction in a small patient population. A larger prospective study is needed to further elucidate the clinical impact of these findings.
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