Revista argentina de cardiología
versión On-line ISSN 1850-3748
VOLBERG, Verónica I. et al. Efficacy of the Peak to Mean Pressure Decrease Ratio for the Assessment of Aortic Stenosis Severity. Rev. argent. cardiol. [online]. 2006, vol.74, n.3, pp. 123-128. ISSN 1850-3748.
The aim of the present study was to evaluate the statistical efficacy of peak to mean pressure decrease ratio (GMAX/ GMED) for the assessment of aortic stenosis severity. We studied the echocardiograms of 212 consecutive patients (mean age: 74 years; range: 19-98 years; 100 males [47%]) with an aortic area calculated by the continuity equation (AAo) of 2 cm2. We considered severe aortic stenosis: a maximal aortic velocity (VMAX) 4 m/s, a mean gradient (GMED) 40 mmHg or an AAo of 1 cm2. We also performed the analysis taking an AAo 0.75 cm2 as severe aortic stenosis. We conclude that: 1) GMAX/ GMED ratio is directly but weakly correlated; 2) There is a great overlap among GMAX/ GMED ratio values corresponding to patients with different aortic stenosis severity; 3) The sensitivity, specificity and accuracy of GMAX/ GMED ratio for the diagnosis of severe aortic stenosis are of average magnitude; 4) The positive and negative predictive values of GMAX/ GMED ratio are modest, in the studied population; 5) The analysis of likelihood ratios demonstrated that GMAX/ GMED ratio has only a small clinical impact for the diagnosis of severe aortic stenosis; 6) More studies are needed before accepting GMAX/ GMED ratio as a useful clinical parameter for the diagnosis of severe aortic stenosis. The GMAX/ GMED ratio could be a surrogate criterion for AAo when it is not possible to assess all the variables needed for its calculation.
Palabras clave : Aortic stenosis; Echocardiography; Doppler.