Related Experiment Videos
Aortic stenosis in children. Experience with echocardiographic prediction of severity
Insights
Echocardiography can predict left ventricular pressure and systolic pressure gradients in children with aortic stenosis. This noninvasive method aids in assessing obstruction severity and monitoring patients with normal left ventricular function.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Noninvasive Hemodynamics
Background:
- Aortic stenosis (AS) in children requires accurate assessment of left ventricular (LV) pressure and gradients.
- Cardiac catheterization, while accurate, is invasive and carries risks.
- Noninvasive methods are crucial for routine monitoring and initial assessment of pediatric AS.
Purpose of the Study:
- To evaluate a novel echocardiographic method for predicting intraventricular systolic pressure (PISP) and systolic pressure gradients in children with aortic stenosis.
- To determine the accuracy and reliability of this noninvasive technique compared to cardiac catheterization.
Main Methods:
- Fifty-six children with aortic stenosis underwent both echocardiography and cardiac catheterization.
- Echocardiography was used to measure the ratio of end-systolic wall thickness (Ws) to LV internal diameter (LVES).
- This ratio was multiplied by 245 to predict LV pressure; arm systolic blood pressure was subtracted to predict the systolic pressure gradient.
Main Results:
- A strong correlation was found between echocardiographically predicted LV pressure and catheterization-derived pressure (r = 0.83).
- A high correlation was observed for predicted systolic pressure gradients (r = 0.91).
- The technique proved effective across a wide range of LV pressures, independent of volume load, and useful for small gradients.
Conclusions:
- Echocardiography provides a reliable noninvasive method for assessing aortic stenosis severity in children with normal LV function.
- This technique is valuable for both initial diagnosis and serial follow-up, regardless of obstruction level or LV pressure.
- The method is practical, reproducible, and addresses common measurement challenges.
Abstract:
Fifty-six children with aortic stenosis were investigated both by echocardiography and cardiac catheterization. The ratio of end-systolic wall thickness (Ws) to internal diameter (LVES) across the minor axis of the LV as determined by echocardiography and multiplied by a factor of 245 predicts left ventricular pressure (r = 0.83). Subtracting the arm systolic blood pressure from the predicted intraventricular systolic pressure (PISP) gives a predicted systolic pressure gradient (r = 0.91). The technique is found to be useful for both initial and sequential noninvasive assessment of aortic stenosis with normal LV function irrespective of the level of obstruction. It is shown to apply equally well to wide range of LV pressures, is independent of volume load, and is useful in predicting small gradients. Some common problems encountered with the measurements are examined in detail.