PLANIMETRY AND TRANSTHORACIC 2-DIMENSIONAL ECHOCARDIOGRAPHY IN NONINVASIVE ASSESSMENT OF AORTIC-VALVE AREA IN PATIENTS WITH VALVULAR AORTIC-STENOSIS

Objectives. The aim of this study was to evaluate the reliability of t ransthoracic two-dimensional echocardiography in measuring aortic valv e area (AVA) by planimetry. Background. Planimetry of AVA using two di mensional transesophageal echocardiographic images has been reported t o be a reliable method for measuring AVA in patients with aortic steno sis. Recent advances in resolution of two-dimensional echocardiography permit direct visualization of an aortic valve orifice from the trans thoracic approach more easily than before. Methods. Forty-two adult pa tients with valvular aortic stenosis were examined. A parasternal shor t-axis view of the aortic valve was obtained,vith transthoracic two-di mensional echocardiography. AVA was measured directly by planimetry of the inner leaflet edges at the time of maximal opening in early systo le. AVA was also measured by planimetry using transesophageal echocard iography, by the continuity equation and by cardiac catheterization (G orlin formula). Results. In 32 (76%) of the 42 study patients, AVA cou ld be detected by using the transthoracic planimetry method. There wer e good correlations between results of transthoracic two-dimensional e chocardiographic planimetry and the continuity equation (y = 0.90x + 0 .09, r = 0.90, p < 0.001, SEE = 0.09 cm(2)), transesophageal echocardi ographic planimetry (y = 1.05x - 0.02, r = 0.98, p < 0.001, SEE = 0.04 cm(2)) and the Gorlin formula (y = 1.02x + 0.05, r = 0.89, p < 0.001, SEE = 0.10 cm(2)). Conclusions. Transthoracic two-dimensional echocar diography provides a feasible and reliable method in measuring AVA in patients with aortic stenosis. (C) 1997 by the American College of Car diology.