Why the study?
Does the highest Doppler signal or the average of multiple signals during atrial fibrillation better estimate aortic stenosis severity compared to assessment during normal sinus rhythm?
Does the highest Doppler signal or the average of multiple signals during atrial fibrillation better estimate aortic stenosis severity compared to assessment during normal sinus rhythm?
This case series investigates whether using the highest Doppler signal or averaging multiple signals in atrial fibrillation better correlates with aortic stenosis severity measured during normal sinus rhythm.
May warrant averaging multiple signals over highest for AS grading in AF; leaves open outcome validation before practice change.
Grading severity of AS in AF is complicated by varying stroke volumes associated with fluctuating maximum velocities and pressure gradients across the aortic valve. Current guidelines recommend averaging five continuous-wave peak velocity and mean gradient (MG) Doppler signals across the aortic valve when estimating severity of AS in AF. However, it is unknown when grading severity of AS how the average of multiple Doppler signals vs the highest Doppler signal in AF compares to the Doppler signals when the patient is in normal sinus rhythm. We present a series of patients with AS who had two echocardiograms performed within 2-4 months of each other, one when in normal sinus rhythm and one when in AF, and compare the aortic valve hemodynamics associated with the two rhythms.
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Alsidawi et al. (2018) studied this question.
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