Key result
A hybrid approach using impedance cardiography and echocardiography yielded a mean aortic valve area of 0.7 cm2, showing no significant difference and strong correlation (r=0.76) compared to invasive measurement.
Why the study?
Does a hybrid approach using impedance cardiography and echocardiography accurately quantify aortic valve area compared to invasive measurement using the Gorlin equation in patients with moderate to severe aortic stenosis?
Cross-Sectional (n=30)
No
Does a hybrid approach using impedance cardiography and echocardiography accurately quantify aortic valve area compared to invasive measurement using the Gorlin equation in patients with moderate to severe aortic stenosis?
A noninvasive hybrid approach combining impedance cardiography and echocardiography provides an accurate and clinically applicable alternative to invasive catheterization for quantifying aortic valve area in patients with moderate to severe aortic stenosis.
BACKGROUND: Impedance cardiography (IC) is a noninvasive modality that utilizes changes in impedance across the thorax to assess hemodynamic parameters, including stroke volume (SV). This study compared aortic valve area (AVA) as assessed by a hybrid approach of transthoracic echocardiography (TTE) and impedance cardiography (IC) to AVA determined at cardiac catheterization using the Gorlin equation. METHODS: A total of 30 patients with moderate to severe aortic stenosis underwent AVA measurement using two different approaches: using the continuity equation (CE) in a hybrid method combining IC and TTE (AVA = stroke by volume impedance cardiography/trans-aortic-VTI) and using the Gorlin equation. Patient age ranged from 37 to 82 years (mean 48); there were 21 men and 9 women. Twenty-five patients were in sinus rhythm, and five had atrial fibrillation. RESULTS: There was no statistically significant difference for the mean AVA between the two methods (0.7 ± 0.24 cm(2) using the Gorlin equation versus 0.7 ± 0.23 cm(2) using the hybrid approach, p = 0.17; r = 0.76, p < 0.001). The mean difference was 0.004 cm(2), and the limits of agreement were -0.33 to 0.37. CONCLUSION: The hybrid method using impedance cardiography and TTE is a reasonable, clinically applicable approach to evaluate AVA and has significant correlation to invasive measurement using the Gorlin equation.
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Daralammouri et al. (2016) conducted a cross-sectional in Moderate to severe aortic valve stenosis (n=30). Hybrid approach (Impedance cardiography and echocardiography) vs. Cardiac catheterization using the Gorlin equation was evaluated on Mean aortic valve area (AVA) in cm2 (r = 0.76, 95% CI -0.33 to 0.37, p=0.17). A hybrid approach using impedance cardiography and echocardiography yielded a mean aortic valve area of 0.7 cm2, showing no significant difference and strong correlation (r=0.76) compared to invasive measurement.
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