Elsevier

American Heart Journal

Volume 103, Issue 2, February 1982, Pages 202-209
American Heart Journal

Reliable estimation of peak left ventricular systolic pressure by M-mode echographic-determined end-diastolic relative wall thickness: Identification of severe valvular aortic stenosis in adult patients

https://doi.org/10.1016/0002-8703(82)90493-8Get rights and content

Abstract

In compensated hearts, left ventricular systolic pressure (LVSP) can be estimated from the ratio of LV wall thickness to chamber radius (RWT). To determine the clinical value of such estimates, we examined echocardiographic RWT in an unscreened series of 81 individuals with aortic valve disease, hypertension, or normal hearts. Despite the presence, in many subjects, of symptoms of congestive heart failure, reduced ejection fraction, or coronary disease, end-diastolic RWT (RWTD) correlated well with peak LVSP (r = 0.77); 45 of 55 patients with LVSP ≥ 140 mm Hg had RWTD ≥ 0.45, while 26 of 26 with LVSP < 140 mm Hg had lower values (p < 0.005). RWTD was ≥ 0.50 in 30 of 34 patients with LVSP ≥ 180 mm Hg and in 6 of 21 with LVSP 140 to 180 mm Hg. RWTD correctly estimated LVSP range in 26 of 27 severe aortic stenosis (AS) patients and, combined with echocardiographic aortic valve calcification, correctly recognized the presence or absence of severe AS in 99% of the series. The RWTD for any given LVSP was higher in patients on antihypertensive treatment and lower in patients with severe aortic regurgitation. In contrast to series based on patients with normal LV function, end-systolic RWT correlated poorly with LVSP.

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    Citation Excerpt :

    Isovolumic relaxation time (IVRT) was measured as the time between aortic valve closure and mitral valve opening by placing a 4-mm sample within the LV outflow tract in the 5-chamber view. Relative wall thickness (RWT) and left ventricular mass of obese subjects was measured as previously described.10,11 LA and LV volumes were measured using 3D echocardiography (X-3 probe, IE33 Phillips Medical Systems, Andover, Massachusetts).

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Supported in part by a research fellowship grant to Dr. Devereux from the American Heart Association, Southeastern Pennsylvania Affiliate.

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