Ratio of Acceleration Time to Ejection Time for Assessing Aortic Stenosis Severity

Area of Science:

• Cardiology
• Echocardiography
• Valvular Heart Disease

Background:

• Aortic stenosis grading inconsistencies are common (24-38%).
• Echocardiographic waveform analysis is recommended for discrepancies.
• The acceleration time to ejection time (AT/ET) ratio is proposed for severity assessment.

Purpose of the Study:

• To evaluate the utility of the AT/ET ratio in assessing aortic stenosis severity.
• To correlate AT/ET ratio with clinical symptoms and echocardiographic parameters.

Main Methods:

• 108 patients with moderate aortic stenosis (valve area < 1.5 cm²) were enrolled.
• Ejection dynamics (AT/ET) and conventional echocardiographic parameters were analyzed.
• Clinical data, symptoms, and NT-proBNP levels were recorded.

Main Results:

• The AT/ET ratio (cutoff 0.35) showed 77% sensitivity and 100% specificity for symptomatic patients.
• Patients with AT/ET > 0.35 had significantly higher NT-proBNP levels (P < 0.001).
• AT/ET correlated well with indexed left ventricle mass (r=0.60), DVI (r=-0.56), and AVA (r=-0.49).

Conclusions:

• The AT/ET ratio is a valuable tool for assessing aortic stenosis severity.
• Ejection dynamics, specifically AT/ET, correlate with flow-independent parameters.
• This ratio aids in the comprehensive evaluation of aortic stenosis.