Assessment of aortic valve area on cardiac computed tomography in symptomatic bicuspid aortic stenosis: Utility and differences from Doppler echocardiography

Kyu Kim, Soo Ji Lee, Jiwon Seo, Young Joo Suh, Iksung Cho, Geu Ru Hong, Jong Won Ha, Young Jin Kim, Chi Young Shim

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Background: In this study, we investigate the utility of geometric orifice area (GOA) on cardiac computed tomography (CT) and differences from effective orifice area (EOA) on Doppler echocardiography in patients with bicuspid aortic stenosis (AS). Methods: A total of 163 patients (age 64 ± 10 years, 56.4% men) with symptomatic bicuspid AS who were referred for surgery and underwent both cardiac CT and echocardiography within 3 months were studied. To calculate the aortic valve area, GOACT was measured by multiplanar CT planimetry, and EOAEcho was calculated by the continuity equation with Doppler echocardiography. The relationships between GOACT and EOAEcho and patient symptom scale, biomarkers, and left ventricular (LV) functional variables were analyzed. Results: There was a significant but modest correlation between EOAEcho and GOACT (r = 0.604, p < 0.001). Both EOAEcho and GOACT revealed significant correlations with mean pressure gradient and peak transaortic velocity, and the coefficients were higher in EOAEcho than in GOACT. EOAEcho of 1.05 cm2 and GOACT of 1.25 cm2 corresponds to hemodynamic cutoff values for diagnosing severe AS. EOAEcho was well correlated with the patient symptom scale and log NT-pro BNP, but GOACT was not. In addition, EOAEcho had a higher correlation coefficient with estimated LV filling pressure and LV global longitudinal strain than GOACT. Conclusion: GOACT can be used to evaluate the severity of bicuspid AS. The threshold for GOACT for diagnosing severe AS should be higher than that for EOAEcho. However, EOAEcho is still the method of choice because EOAEcho showed better correlations with clinical and functional variables than GOACT.

Original languageEnglish
Article number1035244
JournalFrontiers in Cardiovascular Medicine
Publication statusPublished - 2022 Dec 19

Bibliographical note

Funding Information:
This research was supported by the Korean Cardiac Research Foundation (202103-02). The funders had no role in study design, data collection and analysis, the decision to publish, and the preparation of the manuscript.

Publisher Copyright:
Copyright © 2022 Kim, Lee, Seo, Suh, Cho, Hong, Ha, Kim and Shim.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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