[M-mode echocardiography determination of the severity of aortic stenosis: is the assumption of constant wall stress a realistic approach?].

We reevaluated a previously described M-mode echocardiographic method for the assessment of the hemodynamic severity of an isolated or predominant, advanced aortic stenosis in 89 adult patients without significant associated coronary artery disease. Endsystolic left ventricular wall thickness and diameters were measured using the echocardiogram and left ventricular systolic pressure was calculated under the assumption of a constant left ventricular wall stress (235 mm Hg); the results were compared with the pressure values measured during catheterization. The correlation between the echocardiographic and the invasively determined pressure values was poor and without any clinical relevance; r-values ranged between 0.

Chronic aortic regurgitation: reassessment of the prognostic value of preoperative left ventricular end-systolic dimension and fractional shortening.

The prognostic significance of a preoperative echocardiographic left ventricular end-systolic dimension (ESD) greater than 55 mm and/or fractional shortening (FS) of 25% or less was evaluated retrospectively in 84 patients who had undergone aortic valve replacement for isolated chronic aortic regurgitation due to various causes. Postoperative survival, improvement in symptoms, and echocardiographic evidence of regression of left ventricular dilatation and hypertrophy were compared between patients with a preoperative ESD greater than 55 mm (category 1) and those with an ESD of 55 mm or less (category 2) and between patients with FS of 25% or less (category 3) and those with FS greater than 25% (category 4). Patients in categories 1 and 3 had a higher preoperative left ventricular end-diastolic dimension (EDD) and cross-sectional area than those in categories 2 and 4, respectively, but their preoperative functional impairment (NYHA class) was similar.