Variation of anatomic valve area during ejection in patients with valvular aortic stenosis evaluated by two-dimensional echocardiographic planimetry: comparison with traditional Doppler data
Marie Arsenault, MDa,
Navroz Masani, MDa,
Guiseppina Magni, MDa,
Jiefen Yao, MDa,
Luz Deras, MDa and
Natesa Pandian, MDa
a Non-invasive Cardiac Imaging Laboratory, Tufts University, New England Medical Center, Boston, Massachusetts, USA
View larger version (76K):
[in a new window]
|
Figure 1 Examples of two-dimensional planimetry. A, Top row: transthoracic echocardiography (TTE). Bottom row: transesophageal echocardiography (TEE) (NB: two different patients). The valve is seen closed, then maximally open and finally with superimposed planimetry of the valve area. B, Frame by frame planimetry (dotted lines) for one ejection period in moderate aortic stenosis (different patient from top panel). Left, the valve is closed. Progressive opening and closing can be seen in the following frames, returning to complete closure on the right.
|
|
View larger version (31K):
[in a new window]
|
Figure 2 Examples of frame by frame planimetry in three patients with valve area <1 cm2 (A), 1 to 2 cm2 (B) and more than 2 cm2 (C). In each diagragm aortic valve area (AVA) in square centimeters is plotted against time which is expressed in number of video frames (each equal to 33 ms) for one ejection period.
|
|
View larger version (16K):
[in a new window]
|
Figure 3 Opening (A) and closing rate (B) of the aortic valve related to valve area obtained from Doppler data (CE) in square centimeters. Opening and closing rates are calculated by dividing the maximal valve area obtained by planimetry by the time needed to reach that maximal opening or by the time needed to go back to complete closure from that maximal opening respectively and are expressed in square centimeters per s.
|
|
View larger version (17K):
[in a new window]
|
Figure 4 Regression curve for mean versus maximal area by planimetry.
|
|
View larger version (13K):
[in a new window]
|
Figure 5 Maximal and mean area by planimetry versus mean area by Doppler (CE: continuity equation) measurements. A, Regression line for the AVA max pl. versus CE. B, Regression line for the AVA mean pl. versus CE.
|
|
|
