152 Comparison of semi-quantitative and quantitative assessment of AR severity. Clinical implications
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文摘

Background

Recent studies have emphasized the importance of quantitative assessment of valvular regurgitation. However, in clinical practice mainly semi-quantitative methods remain used despite an unclear diagnostic value. We aimed to define the sensitivity and specificity of semi-quantitative methods compared to the PISA for the diagnostic of severe aortic regurgitation (AR).

Methods

Degree of AR was prospectively evaluated using the PISA method and 4 semi-quantitative measurements (cardiac output (CO), pressure half time (PHT), vena contracta (VC) and diastolic flow reversal (DFR)) in 224 patients with a wide range of AR severity. Criteria for severe AR were an ERO 30 mm2, a CO 10 l/min, a PHT < 200 ms, a VC 6 mm or a DFR 18 cm/ s.

Results

Using the PISA method 76 patients (34 % ) had severe AR. Sensitivity, specificity, VPP, VPN of the recommended thresholds of the 4 semi-quantitative methods for severe AR based on ERO are presented in the Table. Overall, semi-quantitative methods had a good specificity but a poor sensitivity except the VC which presented both a good sensitivity and specificity.

Conclusion

align=""left"">Thresholdalign=""center"">Sensitivity, % align=""center"">Specificity, % align=""center"">PPV, % align=""center"">NPV, % align=""center"">AUC
align=""left"">CO10l/malign=""center"">38align=""center"">95align=""center"">81align=""center"">73align=""center"">0.70
align=""left"">VC6 mmalign=""center"">91align=""center"">77align=""center"">65align=""center"">95align=""center"">0.90
align=""left"">DFR18cm/salign=""center"">51align=""center"">86align=""center"">71align=""center"">71align=""center"">0.77
align=""left"">PHT200 msalign=""center"">12align=""center"">100align=""center"">100align=""center"">60align=""center"">0.81

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