ArticleThe international journal of cardiovascular imaging2020
Measurement errors in serial echocardiographic assessments of aortic valve stenosis severity.
Article in The international journal of cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 25 citations in OpenAlex.
- Moderate aortic stenosis: diagnostic pitfalls and the role of multimodality imaging in risk stratification and clinical management.Cardiovascular ultrasound · 2026Review
- Assessment of preload responsiveness by variation in peak aortic flow velocity in suprasternal window: A novel approach.Indian journal of anaesthesia · 2026Article
- Noise in clinical data: insights from assessment of aortic stenosis by echocardiography.Cardiovascular ultrasound · 2026Review
- Utility of Echocardiography in 173 VA ECMO Clamp Trials in Babies and Children.Pediatric cardiology · 2026Article
- A Randomized Trial Evaluating Automated Notifications for the Identification and Treatment of Aortic Stenosis and Mitral Regurgitation: The ALERT Study.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Continuous wave doppler pre-attenuation velocity envelope: a promising tool for the echocardiographic assessment of aortic stenosis.Echo research and practice · 2025Article
- Unraveling the Enigma of Moderate Aortic Stenosis: Challenges and Future Prospects.Journal of clinical medicine · 2024Review
- Diagnostic Challenges in Aortic Stenosis.Journal of cardiovascular development and disease · 2024Review
- Aortic Valve Calcium Score by Computed Tomography as an Adjunct to Echocardiographic Assessment-A Review of Clinical Utility and Applications.Journal of imaging · 2023Review
- Deep learning for automated left ventricular outflow tract diameter measurements in 2D echocardiography.Cardiovascular ultrasound · 2023Article
- Echocardiographic Evaluation of Aortic Stenosis: A Comprehensive Review.Diagnostics (Basel, Switzerland) · 2023Review
- Pitfalls and Tips in the Assessment of Aortic Stenosis by Transthoracic Echocardiography.Diagnostics (Basel, Switzerland) · 2023Review
- Intra-and inter-observer variability of point of care ultrasound measurements to evaluate hemodynamic parameters in healthy volunteers.The ultrasound journal · 2023Article
- Severe low-gradient aortic stenosis: impact of inadequate left ventricular responses to high afterload on diagnosis and therapeutic decision-making.Heart failure reviews · 2022Review
- Progressive Calcification in Bicuspid Valves: A Coupled Hemodynamics and Multiscale Structural Computations.Annals of biomedical engineering · 2021Article
- Forward Left Ventricular Ejection Fraction as a Predictor of Postoperative Left Ventricular Dysfunction in Patients with Degenerative Mitral Regurgitation.Journal of clinical medicine · 2021Article
- Quantification of aortic valve area: comparison of different methods of echocardiography with 3-D scan of the excised valve.The international journal of cardiovascular imaging · 2021Article
- Aortic valve calcification scoring with computed tomography: impact of iterative reconstruction techniques.The international journal of cardiovascular imaging · 2020Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
Transthoracic echocardiography (TTE) evaluation of aortic stenosis (AS) is routinely performed using the continuity equation. Inaccurate measurements of the left ventricular (LV) outflow tract (LVOT) diameter are considered the most common source of error in AS grading. We hypothesized that inconsistency in LVOT velocity time integral (VTI) is an under-recognized cause of AS assessment error. We sought to determine which parameters contribute most towards inconsistencies in AS grading by studying the prevalence of different errors in a historic cohort. We identified patients with mild to severe AS with multiple studies from our database from 1994 to 2018 (n = 988 patients, 2859 studies). Errors were defined when: (1) LVOT diameter changed by > 2 mm, (2) LVOT VTI changed by > 15% without change in LV function from the initial TTE, (3) aortic valve (AV) maximum velocity (Vmax), mean pressure gradient (ΔP) or AV VTI decreased by > 15% without change in LV function from prior study. The most common error was the LVOT VTI measurement with 22% prevalence. LVOT diameter, AV VTI, AV Vmax and AV ΔP measurement caused errors in < 7% studies. Patients with normal LV function and more severe AS were more likely to have LVOT VTI errors (P < 0.05). LVOT VTI is a frequent, under-recognized source of error in assessing AS. Greater attention should be directed toward the proper positioning of the pulsed Doppler sample volume, particularly in patients with higher grades of AS and normal systolic function, to ensure accurate and reproducible assessment of AS.
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