scholarly journals Indirect ultrasound evaluation of left ventricular outflow tract diameter implications for heart failure and aortic stenosis severity assessment

2021 ◽  
Author(s):  
Gabriele Pestelli ◽  
Andrea Fiorencis ◽  
Valeria Pergola ◽  
Giovanni Andrea Luisi ◽  
Vittorio Smarrazzo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Stenosis ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Severity Assessment ◽  
Ultrasound Evaluation ◽  
Stenosis Severity ◽  
Left Ventricular Outflow

scholarly journals INDIRECT ULTRASOUND EVALUATION OF LEFT VENTRICULAR OUTFLOW TRACT DIAMETER IMPLICATIONS FOR HEART FAILURE AND AORTIC STENOSIS SEVERITY ASSESSMENT.

2020 ◽  
Author(s):  
Gabriele Pestelli ◽  
Andrea Fiorencis ◽  
Valeria Pergola ◽  
Giovanni Luisi ◽  
Vittorio Smarrazzo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Stenosis ◽  
Aortic Root ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Regression Equation ◽  
Ultrasound Evaluation ◽  
Left Ventricular Outflow

Background. Whereas dependency of left ventricular outflow tract diameter (LVOTD) from body surface area (BSA) has been established and a BSA-based LVOTD formula has been derived, the relationship between LVOTD and aortic root and LV dimensions has never been explored. This may have implications for evaluation of LV output in heart failure (HF) and aortic stenosis (AS) severity. Methods. A cohort of 540 HF patients who underwent transthoracic echocardiography was divided in a derivation and validation subgroup. In the derivation subgroup (N=340) independent determinants of LVOTD were analyzed to derive a regression equation, which was used for predicting LVOTD in the validation subgroup (N=200) and compared with the BSA-derived formula. Results. LVOTD determinants in the derivation subgroup were sinuses of Valsalva diameter (SVD, beta=0.392, P<0.001), BSA (beta=0.229, P<0.001), LV end-diastolic diameter (LVEDD, beta=0.145, P=0.001), and height (beta=0.125, P=0.037). The regression equation for predicting LVOTD with the aforementioned variables (LVOTD=6.209+[0.201xSVD]+[1.802xBSA]+[0.03xLVEDD]+[0.025xHeight]) did not differ from (P=0.937) and was highly correlated with measured LVOTD (R=0.739, P<0.001) in the validation group. Repeated analysis with LV end-diastolic volume instead of LVEDD and/or accounting for gender showed similar results, whereas BSA-derived LVOTD values were different from measured LVOTD (P<0.001). Conclusion. Aortic root and LV dimensions affect LVOTD independently from anthropometric data and are included in a new comprehensive equation for predicting LVOTD. This should improve evaluation of LV output in HF and severity of AS, avoiding use of LVOT velocity-time integral alone, which can be misleading, especially when LV cavity and aortic root dimensions are abnormal.

scholarly journals Three-Dimensional Morphology of the Left Ventricular Outflow Tract: Impact on Grading Aortic Stenosis Severity

2017 ◽  
Vol 30 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Luis Caballero ◽  
Daniel Saura ◽  
María José Oliva-Sandoval ◽  
Josefa González-Carrillo ◽  
María Dolores Espinosa ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Left Ventricular Outflow Tract ◽  
Three Dimensional ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Stenosis Severity ◽  
Left Ventricular Outflow

New Left Ventricular Outflow Tract Measurement for Assessment of Aortic Stenosis: Inter- and Intra-observer Variability and Reproducibility

2010 ◽  
Vol 19 ◽  
pp. S190
Author(s):  
C. Chao ◽  
L. Watson ◽  
T. Hetherington ◽  
L. Marquart ◽  
K. Mallitt ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Left Ventricular Outflow Tract ◽  
New Left ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Observer Variability ◽  
Left Ventricular Outflow

Aortic stenosis and left ventricular outflow tract obstruction

ESC CardioMed ◽  
2018 ◽  
pp. 807-810
Author(s):  
David Anderson
Keyword(s):  
Aortic Stenosis ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Long Term Follow Up ◽  
Balloon Valvotomy ◽  
Left Ventricular Outflow

Left ventricular outflow tract obstruction can occur at subvalvar, valvar, and supravalvar levels. Severity and progression can be evaluated by echocardiography. Aortic valve stenosis can usually be relieved by balloon valvotomy, but some patients require surgery, either with valvotomy, valve replacement, or the Ross procedure. Sub- and supravalvar aortic stenosis require surgical management. Long-term follow-up of all patients is required.

scholarly journals Subaortic stenosis and mitral dysplasia in three Black Russian Terrier puppies

2012 ◽  
Vol 50 (No. 7) ◽  
pp. 321-326
Author(s):  
J. Pikula ◽  
J. Pikulova ◽  
H. Bandouchova ◽  
P. Kohout ◽  
K. Najman ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Stenosis ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Subaortic Stenosis ◽  
Maximum Pressure ◽  
Mitral Insufficiency ◽  
Left Ventricular Outflow

A combined congenital heart defect of aortic stenosis and mitral dysplasia was diagnosed in three Black Russian Terrier puppies two months old. The aortic stenosis component included both fixed and dynamic obstructions. The fixed obstruction was subvalvularly located at the entrance to the left ventricular outflow tract. The dynamic obstruction was caused by the septal leaflet of the mitral valve protruding into the left ventricular outflow tract. Mitral dysplasia resulted in mitral insufficiency leading to regurgitation through the mitral valve closer to the septal side. The maximum pressure gradient across the aortic valve amounting to 103 mmHg measured in one puppy was consistent with the most severe grade of stenosis. The diagnosis was confirmed by autopsy in all three puppies that were males and originated in one litter, so genetic influences are supposed.

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