Valvular & structural heart disease
The ratio of measured and reference effective orifice areas for discriminating prosthetic aortic valve obstruction
Authors' conclusion
The ratio of measured/reference EOA adds incremental value over conventional Doppler parameters and might be helpful for distinguishing PAV obstruction.
Study context
- Population
- Mechanical prosthetic aortic valve (PAV) patients with elevated mean transprosthetic pressure gradient (PG) >20 mmHg or peak velocity >3 m/s
- Participants
- 193 patients
- Comparison
- Measured/reference effective orifice area (EOA) ratio for discriminating mechanical PAV obstruction
- Obstructionn = 143
- Outcome
- Discrimination of mechanical PAV obstruction by measured/reference EOA ratio
Methodological detailsretrospective, EOA measured by continuity equation; reference EOA from previous guidelines
- Retrospective
- EOA measured by continuity equation; reference EOA from previous guidelines
Performance
As reported in the abstract
Measured/reference EOA ratio
Obstruction
0.63
± 0.18
No obstruction
0.86
± 0.17
P < 0.001
- EOA ratio AUC for discriminating PAV obstruction
- 0.840 (95% CI 0.783-0.898; P < 0.001)
- Cutoff 0.71 sensitivity
- 73.4%
- Cutoff 0.71 specificity
- 82.0%
Further findings
| Outcome | AUC | P value |
|---|---|---|
| Novel algorithm (adding EOA ratio) vs previous guideline algorithmsSimilar accuracy | 0.763 vs. 0.731 | P = 0.309 |
| Novel vs previous algorithm in large PAV (≥23 mm) (subgroup)Higher accuracy with novel algorithm | 0.788 vs. 0.642 | P = 0.019 |
Original publication
The ratio of measured and reference effective orifice areas for discriminating prosthetic aortic valve obstruction. Eur Heart J Cardiovasc Imaging. Published 31 October 2022. doi:10.
Summarised from the published abstract; every number is checked against it