Aortic Stenosis - how severe is severe?

Abstract

computer based echocardiographic data of 544 adults patients with pure aortic stenosis was retrieved from the last 03 years on line record. The data was analyzed employing SPSS 8.0 version. Mean age was 37.95 + 21.6 years. Mean left ventricular end diastolic dimension was 5.08 + 1.1cm and end systolic dimension was 3.59 + 1.1cm. Left ventricular size did not enlarge with increase in aortic valve gradient (AVG), age, left atrial size was 3.95 + 1.23 cm and increased with increase AVG RV and or left ventricular (LV) function. RV size was 2.05 + .56cm. It increased with increase in LV end diastolic, diameter and LV wall thickness. Right ventricular (RV) size increased beyond 2.5cm as LA increased more than 4cm RV size was inversely related to fractional shortening fractional shortening (FS) reduced with increase in LV size beyond 5.8cm (p>.0001). FS correlated inverely with increase in LA (p<0001). Peak aortic valve gradient was (AVG) 56.96 + 24.67 mmHg and and mean AVG was 34.38 + 1552. AVG had increase correlation with FS. LV wall thickenss increased with increase in AVG(p<001). AVG mean of 59mmhg and peak of 74mmHg seemed critical as LV hypertrophies on further increase. As, FS reduces as AS progresses and peak AVG of 74 mmHG and mean gradient of 50mmHg shall be the standard for documenting severe AS in adults.