Simplified continuity equation: a simple, accurate, and noninvasive method in the evaluation of aortic stenosis

Traditional evaluation of aortic stenosis usually requires cardiac catheterization for estimation of aortic valve area by the Gorlin formula. However, it is invasive and has been shown to be inaccurate in the presence of aortic regurgitation or low cardiac output. Evaluation of aortic stenosis by Doppler echocardiography using a continuity equation has been proved to have excellent correlation with cardiac catheterization. It requires hand tracing and computer software for calculation of time velocity integral. Recently, a simplified continuity equation was introduced, which uses the peak velocities instead of time velocity integrals. It saves time and obviates the computer assistance. The purpose of this study is to evaluate its accuracy using the standard continuity equation as the reference standard. Seventy patients with pure or combined aortic stenosis were examined. There was an excellent correlation between these two methods (r = 0.979, 95% confidence interval: 0.978-0.980). The aortic valve area derived from the peak velocity method = 0.018 + 0.949 X aortic valve area derived from the time velocity integral. The difference between the two methods was 0.04 +/- 0.08 cm2 (mean +/- SD) with a 95% confidence interval of -0.12 to 0.20 cm2. Furthermore, the correlation still remained good even in the presence of significant aortic regurgitation or impaired left ventricular function. In conclusion, the simplified continuity equation is a safe, time-saving, and accurate method for the evaluation of aortic stenosis.