Chest roentgenographic evaluation of the severity of aortic stenosis

The chest radiographs of 44 adult patients with proven valvular aortic stenosis (AS) were analyzed for the evaluation of severity of the disease. Five parameters were correlated with the aortic valve area (AVA) as the determinant of AS severity: the area of aortic valve calcification (AVCa), the cardio--thoracic (C--T) ratio, the Hoffman-Rigler (H-R) sign, left atrial enlargement (LAE), and the transverse diameter of the thoracic aorta (TDAo). There was a significant correlation between AVCa and severe AS only in women over 40 years of age. The increased C--T ratio and evidence of LAE was predictive of severe AS in men over 40 years of age. The positive H-R sign and an increased TDAo were not useful in assessing the severity of AS. Accordingly, the radiographic analysis of signs is a simple, useful, and noninvasive technique for diagnosing AS and for assessing its severity in patients over 40 years of age.