Resumo

VOLBERG, Verónica I. et al. Efficacy of the Peak to Mean Pressure Decrease Ratio for the Assessment of Aortic Stenosis Severity. Rev. argent. cardiol. [online]. 2006, vol.74, n.3, pp.123-128. ISSN 1850-3748.

The aim of the present study was to evaluate the statistical efficacy of peak to mean pressure decrease ratio (G_MAX/ G_MED) for the assessment of aortic stenosis severity. We studied the echocardiograms of 212 consecutive patients (mean age: 74 years; range: 19-98 years; 100 males [47%]) with an aortic area calculated by the continuity equation (AAo) of 2 cm². We considered severe aortic stenosis: a maximal aortic velocity (V_MAX) 4 m/s, a mean gradient (G_MED) 40 mmHg or an AAo of 1 cm². We also performed the analysis taking an AAo 0.75 cm² as severe aortic stenosis. We conclude that: 1) G_MAX/ G_MED ratio is directly but weakly correlated; 2) There is a great overlap among G_MAX/ G_MED ratio values corresponding to patients with different aortic stenosis severity; 3) The sensitivity, specificity and accuracy of G_MAX/ G_MED ratio for the diagnosis of severe aortic stenosis are of average magnitude; 4) The positive and negative predictive values of G_MAX/ G_MED ratio are modest, in the studied population; 5) The analysis of likelihood ratios demonstrated that G_MAX/ G_MED ratio has only a small clinical impact for the diagnosis of severe aortic stenosis; 6) More studies are needed before accepting G_MAX/ G_MED ratio as a useful clinical parameter for the diagnosis of severe aortic stenosis. The G_MAX/ G_MED ratio could be a surrogate criterion for AAo when it is not possible to assess all the variables needed for its calculation.

Palavras-chave : Aortic stenosis; Echocardiography; Doppler.