Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Azizbaig Mohajer, S.
Vergleich zwischen echokardiografischer und invasiver Bestimmung des Schweregrades der Aortenstenose
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 64
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Rainer Peter
- Zweiker David
- Altmetrics:
- Abstract:
- Introduction: Aortic valve stenosis (AS) is the most common acquired valvular heart defect in developed countries. Nowadays, the assessment and classification of AS are primarily performed through echocardiography. In some centers, invasive hemodynamic analysis is still performed in cardiac catheterizations to characterize these patients. The aim of this study is to classify AS using invasive hemodynamic and echocardiographic parameters and to compare them with each other. Methods: This retrospective data analysis reviews patients with severe AS, who received transcatheter aortic valve implantation (TAVI) at the Division of Cardiology, Medical University of Graz between May 2007 and December 2019. Descriptive statistics were obtained regarding population demographics, comorbidities, medication, laboratory parameters, and echocardiographic and invasive hemodynamic parameters. Patients who met the inclusion criteria were classified and compared based on echocardiographic and invasive hemodynamic parameters into mild, moderate, severe AS and into the non-classical subtypes high-gradient (HG), low-flow, low-gradient (LF/LG), and normal-flow, low-gradient (NF/LG) AS. Results: Of 1156 patients, only 275 met the inclusion criteria, i.e., both echocardiographic and all required invasive parameters were available. 61.1% (168/275) of the classifications determined by the two measurement methods were concordant. 15.3% (42/275) of echocardiographically determined HG AS were identified as LF/LG or NF/LG AS on cardiac catheterization. Conversely, 5.1% (14/275) of the patients classified as HG AS on cardiac catheterization were echocardiographically identified as LF/LG or NF/LG AS. Conclusion: This study showed that inconsistency between echocardiography and cardiac catheterization mainly concerned the non-classical AS subtypes, i.e., HG, LF/LG, and NF/LG AS. Both examination methods are important diagnostic tools for assessing AS severity and can complement one another. The final assessment also integrates the patient's clinical presentation and other required diagnostic tests that have to be considered when determining the individualized treatment plan and the indication for valve replacement.