An easy and reproducible parameter for the assessment of the pressure gradient in patients with aortic stenosis disease

A magnetic resonance study

Valentina Valenti, Sebastiano Sciarretta, Matt Levin, Leon Shubayev, Sophia Edelstein, Mohammad I. Zia, Speranza Rubattu, Massimo Volpe, Seth Uretsky, Steven D. Wolff

Research output: Contribution to journalArticle

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Abstract

Aim: Cardiovascular magnetic resonance (CMR) has been increasingly used as an alternative method to evaluate the severity of aortic stenosis. The aim of our study was to evaluate whether the indirect measurement of the aortic gradient (Calc-PG), derived from Gorlin's formula, is a reproducible parameter for gradient assessment. Then, we evaluated if this parameter is correlated with left ventricular hypertrophy, considered as a marker of severity of aortic stenosis, better than phase-contrast sequences-derived pressure gradient (PC-PG) and aortic valve area. Methods: Forty-one patients with isolated aortic stenosis underwent CMR. Calc-PG was obtained from the formula (cardiac output/aortic valve area)2, and it was compared to PC-PG. Results: We found that the Calc-PG has higher correlation with left ventricle mass than PC-PG (r2 0.44, p<0.001 vs. r2 0.26, p<0.01), also after multivariate analysis adjusting for age, gender and hypertension (p<0.001). Furthermore, Calc-PG was more reproducible than PC-PG. The receiver operating characteristic comparison curve analysis showed that Calc-PG has a significantly higher ability to describe the presence of left ventricular hypertrophy than PC-PG (area under the curve 0.85, 95% CI 0.70-0.94, p<0.0001 vs. 0.74, 95% CI 0.58-0.87, p=0.03). Conclusions: We propose that transaortic gradient indirectly calculated by using the simplified Gorlin's equation could be an alternative method to assess the severity of aortic stenosis.

Original languageEnglish (US)
Pages (from-to)369-376
Number of pages8
JournalJournal of Cardiology
Volume65
Issue number5
DOIs
StatePublished - May 1 2015

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Aortic Diseases
Aortic Valve Stenosis
Magnetic Resonance Spectroscopy
Pressure
Left Ventricular Hypertrophy
Aortic Valve
ROC Curve
Cardiac Output
Area Under Curve
Heart Ventricles
Multivariate Analysis
Hypertension

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Valenti, Valentina ; Sciarretta, Sebastiano ; Levin, Matt ; Shubayev, Leon ; Edelstein, Sophia ; Zia, Mohammad I. ; Rubattu, Speranza ; Volpe, Massimo ; Uretsky, Seth ; Wolff, Steven D. / An easy and reproducible parameter for the assessment of the pressure gradient in patients with aortic stenosis disease : A magnetic resonance study. In: Journal of Cardiology. 2015 ; Vol. 65, No. 5. pp. 369-376.
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abstract = "Aim: Cardiovascular magnetic resonance (CMR) has been increasingly used as an alternative method to evaluate the severity of aortic stenosis. The aim of our study was to evaluate whether the indirect measurement of the aortic gradient (Calc-PG), derived from Gorlin's formula, is a reproducible parameter for gradient assessment. Then, we evaluated if this parameter is correlated with left ventricular hypertrophy, considered as a marker of severity of aortic stenosis, better than phase-contrast sequences-derived pressure gradient (PC-PG) and aortic valve area. Methods: Forty-one patients with isolated aortic stenosis underwent CMR. Calc-PG was obtained from the formula (cardiac output/aortic valve area)2, and it was compared to PC-PG. Results: We found that the Calc-PG has higher correlation with left ventricle mass than PC-PG (r2 0.44, p<0.001 vs. r2 0.26, p<0.01), also after multivariate analysis adjusting for age, gender and hypertension (p<0.001). Furthermore, Calc-PG was more reproducible than PC-PG. The receiver operating characteristic comparison curve analysis showed that Calc-PG has a significantly higher ability to describe the presence of left ventricular hypertrophy than PC-PG (area under the curve 0.85, 95{\%} CI 0.70-0.94, p<0.0001 vs. 0.74, 95{\%} CI 0.58-0.87, p=0.03). Conclusions: We propose that transaortic gradient indirectly calculated by using the simplified Gorlin's equation could be an alternative method to assess the severity of aortic stenosis.",
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An easy and reproducible parameter for the assessment of the pressure gradient in patients with aortic stenosis disease : A magnetic resonance study. / Valenti, Valentina; Sciarretta, Sebastiano; Levin, Matt; Shubayev, Leon; Edelstein, Sophia; Zia, Mohammad I.; Rubattu, Speranza; Volpe, Massimo; Uretsky, Seth; Wolff, Steven D.

In: Journal of Cardiology, Vol. 65, No. 5, 01.05.2015, p. 369-376.

Research output: Contribution to journalArticle

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T1 - An easy and reproducible parameter for the assessment of the pressure gradient in patients with aortic stenosis disease

T2 - A magnetic resonance study

AU - Valenti, Valentina

AU - Sciarretta, Sebastiano

AU - Levin, Matt

AU - Shubayev, Leon

AU - Edelstein, Sophia

AU - Zia, Mohammad I.

AU - Rubattu, Speranza

AU - Volpe, Massimo

AU - Uretsky, Seth

AU - Wolff, Steven D.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Aim: Cardiovascular magnetic resonance (CMR) has been increasingly used as an alternative method to evaluate the severity of aortic stenosis. The aim of our study was to evaluate whether the indirect measurement of the aortic gradient (Calc-PG), derived from Gorlin's formula, is a reproducible parameter for gradient assessment. Then, we evaluated if this parameter is correlated with left ventricular hypertrophy, considered as a marker of severity of aortic stenosis, better than phase-contrast sequences-derived pressure gradient (PC-PG) and aortic valve area. Methods: Forty-one patients with isolated aortic stenosis underwent CMR. Calc-PG was obtained from the formula (cardiac output/aortic valve area)2, and it was compared to PC-PG. Results: We found that the Calc-PG has higher correlation with left ventricle mass than PC-PG (r2 0.44, p<0.001 vs. r2 0.26, p<0.01), also after multivariate analysis adjusting for age, gender and hypertension (p<0.001). Furthermore, Calc-PG was more reproducible than PC-PG. The receiver operating characteristic comparison curve analysis showed that Calc-PG has a significantly higher ability to describe the presence of left ventricular hypertrophy than PC-PG (area under the curve 0.85, 95% CI 0.70-0.94, p<0.0001 vs. 0.74, 95% CI 0.58-0.87, p=0.03). Conclusions: We propose that transaortic gradient indirectly calculated by using the simplified Gorlin's equation could be an alternative method to assess the severity of aortic stenosis.

AB - Aim: Cardiovascular magnetic resonance (CMR) has been increasingly used as an alternative method to evaluate the severity of aortic stenosis. The aim of our study was to evaluate whether the indirect measurement of the aortic gradient (Calc-PG), derived from Gorlin's formula, is a reproducible parameter for gradient assessment. Then, we evaluated if this parameter is correlated with left ventricular hypertrophy, considered as a marker of severity of aortic stenosis, better than phase-contrast sequences-derived pressure gradient (PC-PG) and aortic valve area. Methods: Forty-one patients with isolated aortic stenosis underwent CMR. Calc-PG was obtained from the formula (cardiac output/aortic valve area)2, and it was compared to PC-PG. Results: We found that the Calc-PG has higher correlation with left ventricle mass than PC-PG (r2 0.44, p<0.001 vs. r2 0.26, p<0.01), also after multivariate analysis adjusting for age, gender and hypertension (p<0.001). Furthermore, Calc-PG was more reproducible than PC-PG. The receiver operating characteristic comparison curve analysis showed that Calc-PG has a significantly higher ability to describe the presence of left ventricular hypertrophy than PC-PG (area under the curve 0.85, 95% CI 0.70-0.94, p<0.0001 vs. 0.74, 95% CI 0.58-0.87, p=0.03). Conclusions: We propose that transaortic gradient indirectly calculated by using the simplified Gorlin's equation could be an alternative method to assess the severity of aortic stenosis.

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