Validity of visual assessment of aortic valve morphology in patients with aortic stenosis using two-dimensional echocardiography

Figures

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  Fig. 1. Flowchart of patient dispositions and analysis performed. TTE transthoracic echocardiography, MSCT multislice computed tomography, ctCS calcium score derived by computed tomography, VS visual score, AS aortic stenosis

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  Fig. 2. Bland–Altman plots of intra- and inter-observer agreement in AV visual score (for intra-observer plot 95% limits of agreement − 2.16, 2.97, mean difference 0.43, for inter-observer plot 95% limits of agreement − 4.34, 2.79, mean difference − 0.78)

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  Fig. 3. Visual score (VS) in groups by AV abnormality. Boxes indicate the 25th to 75th percentiles, the line within the boxes indicate median value, the vertical line indicates 95% range for VS. Differences between groups are shown when significant. p < 0.0001 between patients with normal AV and each other group. p < 0.0001 for Kruskal–Wallis test

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  Fig. 4. ROC curves for the detection of AS of any grade (a) and severe AS (b) by visual score in women and men

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  Fig. 5. Examples on visual scoring in patients with various aortic valve abnormality. On the left—patient with aortic sclerosis, in the middle—patient with mild aortic stenosis, on the right—patient with severe aortic stenosis. See Online Resources for complimentary video-loops (ESM_1 and ESM_2 for visual score of 3, ESM_3 and ESM_4 for visual score of 6, ESM_5 and ESM_6 for visual score of 10)

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  Fig. 6. Clinical application of the visual score for the assessment of aortic stenosis. TTE transthoracic echocardiography, TEE transesophageal echocardiography