Doppler echocardiography demonstrated higher accuracy than clinical evaluation for detecting significant valvular disease, achieving overall accuracies of 95% to 100% across specific lesions.
Observational (n=75)
Does Doppler echocardiography have higher accuracy than clinical evaluation in detecting significant valvular heart disease?
Doppler echocardiography is significantly more accurate than clinical evaluation for assessing valvular heart disease severity, potentially reducing the need for diagnostic cardiac catheterization.
We tested the hypotheses that Doppler echocardiography has a higher accuracy than clinical evaluation in the detection of significant aortic and mitral valvular heart disease and that Doppler echocardiography is highly accurate as compared with cardiac catheterization for the assessment of valvular disease severity. Thus, cardiac catheterization for the assessment of valve lesion severity may be unnecessary in selected patients. We prospectively evaluated 75 consecutive patients, ages 20-74 years (mean, 52 years), with clinically suspected valvular heart disease. Specific clinical and Doppler echocardiographic criteria were used to categorize each valve lesion as absent, insignificant, or significant. Criteria for a significant lesion at cardiac catheterization was an aortic or mitral valve area less than 1.1 or 1.5 cm2, respectively, or equal to or greater than 3+ cm2 aortic or mitral regurgitation at angiography. In all valve lesions, Doppler echocardiography had a higher overall accuracy than clinical evaluation. Increases in accuracies of 28%, 19%, 15%, and 7% occurred for mitral stenosis, aortic stenosis, aortic regurgitation, and mitral regurgitation, respectively, resulting in overall accuracies of 97%, 100%, 95%, and 96%. Clinical evaluation alone made 28 errors (37% of patients and 19% of valve lesions assessed), and 17 of these errors (23% of patients and 12% of valve lesions) would have resulted in inappropriate management. In only four (24%) of these 17 patients, the attending cardiologist would not have proceeded to assess the valve at cardiac catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)
Jaffe et al. (Mon,) conducted a observational in clinically suspected valvular heart disease (n=75). Doppler echocardiography vs. Clinical evaluation was evaluated on Accuracy in the detection of significant aortic and mitral valvular heart disease. Doppler echocardiography demonstrated higher accuracy than clinical evaluation for detecting significant valvular disease, achieving overall accuracies of 95% to 100% across specific lesions.