Obtaining correlation between echocardiography and cardiac computed tomography measurements in severe aortic stenosis patients

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Background: as the human body advances with age, all organs go through different aging mechanisms. The aortic valve is under continuous pressure change from the moment the embryo has heartbeat. With age, calcification, fibrotic changes and degeneration take place in the leaflets and the fibrotic annule of the valve, concluding in severe aortic stenosis (AS), and often in aortic regurgitation (AR). Severe AS provides resistance of the blood flow from the left ventricle to the body, causing global ischemia. With echocardiography, it is possible to measure the extent of the degeneration. With cardiac-CT (CCT), morphological parameters and contrast densities in different territories can be evaluated. Aims/methods: 57 patients were enrolled in the study all with severe AS during pre-TAVI evaluation. With echocardiography, peak and mean transvalvular gradients and velocity, along with valve opening area during systole were measured. With CCT, contrast densities (HU) were measured in the left ventricular outflow tract (LVOT), in the non-coronary cusp (NCC), left coronary cusp (LCC); right coronary cusp (RCC), at the Sino-tubular junction (STJ) and 4cm from the STJ (4STJ). Correlation between any of these parameters were to be investigated. Results: with regards to the densities in the selected territories, significant correlation was only found between the aortic valve area and all HU measurements: LVOT R=-0,288, p=0,030; RCC R=-0,334, p=0,011; NCC R=-0,34, p=0,009; LCC R=-0,372, p=0,004; R=-0,312, p=0,018, and 4STJ R=-0,291, p=0,028. When looking for correlation between gradients and velocity, no significant results were found. Conclusion: significant correlation was only found when comparing the valve area parameters measured by echocardiography with any of the densities- thus, certain CCT values can predict the valve area progress. More sophisticated measurement methods need to be used to find out why only the area provided good correlation.

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severe aortic stenosis, TAVI, cardiac computed tomography, echocardiography
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