 |
|
Doppler Echocardiography in Adults With Symptomatic Aortic StenosisDiagnostic Utility and Cost-effectiveness
Catherine M. Otto, MD;
Alan S. Pearlman, MD
Arch Intern Med. 1988;148(12):2553-2560.
Abstract
| |
• To evaluate the diagnostic utility and cost-effectiveness of Doppler echocardiography in adults with symptomatic aortic stenosis, we performed a prospective study in which the need for aortic valve replacement (AVR) was the outcome event. The total sample consisted of 103 adults (mean age, 69 years) undergoing cardiac catheterization for suspected aortic stenosis. Twenty-six patients (25%) were used as a training set to develop a clinical prediction rule. (1) If maximum aortic jet velocity (Vmax) was more than 4.0 m/s, AVR was recommended. (2) If Vmax was less than 3.0 m/s, AVR was not needed. (3) If Vmax was 3.0 to 4.0 m/s and (a) Doppler aortic valve area (AVA) was 1.0 cm2 or less, AVR was recommended, while (b) if Doppler AVA was 1.7 cm2 or greater, AVR was not needed, and (c) if Doppler AVA was 1.1 to 1.6 cm2, consideration of the degree of coexisting aortic insufficiency was necessary. When this rule was applied to the test set (n=77), the sensitivity was 98%, with a specificity of 89% and a total error rate of 3.9%. The approach could have resulted in cost savings between 24% and 34% compared with an invasive diagnostic approach.
(Arch Intern Med 1988;148:2553-2560)
Author Affiliations
From the Division of Cardiology, Department of Medicine, University of Washington, Seattle. Dr Otto was a research fellow of the American Heart Association, Washington Affiliate, Seattle.
Footnotes
Accepted for publication July 14, 1988.
Read before the 58th Scientific Session of the American Heart Association, Washington, DC, Nov 12, 1985.
Reprint requests to Division of Cardiology, RG-22, University of Washington, Seattle, WA 98195 (Dr Otto).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Relationship of Metabolic Syndrome With Incident Aortic Valve Calcium and Aortic Valve Calcium Progression: The Multi-Ethnic Study of Atherosclerosis (MESA)
Katz et al.
Diabetes 2009;58:813-819.
ABSTRACT
| FULL TEXT
Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice
Baumgartner et al.
Eur J Echocardiogr 2009;10:1-25.
FULL TEXT
Features of the Metabolic Syndrome and Diabetes Mellitus as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis
Katz et al.
Circulation 2006;113:2113-2119.
ABSTRACT
| FULL TEXT
Angiotensin-Converting Enzyme Inhibitors and Change in Aortic Valve Calcium
O'Brien et al.
Arch Intern Med 2005;165:858-862.
ABSTRACT
| FULL TEXT
Clinical efficacy of Doppler-echocardiographic indices of aortic valve stenosis:a comparative test-based analysis of outcome
Bermejo et al.
J Am Coll Cardiol 2003;41:142-151.
ABSTRACT
| FULL TEXT
To operate or not on elderly patients with aortic stenosis: the decision and its consequences
Bouma et al.
Heart 1999;82:143-148.
ABSTRACT
| FULL TEXT
Prospective Study of Asymptomatic Valvular Aortic Stenosis : Clinical, Echocardiographic, and Exercise Predictors of Outcome
Otto et al.
Circulation 1997;95:2262-2270.
ABSTRACT
| FULL TEXT
ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography
Cheitlin et al.
Circulation 1997;95:1686-1744.
FULL TEXT
Where Does Ultrasound Stand in Technology Assessment and Outcomes Research: Issues, Methods, and Questions
Waggoner
Journal of Diagnostic Medical Sonography 1996;12:63-68.
ABSTRACT
|
