Hemodynamic progression of aortic stenosis in adults assessed by Doppler echocardiography

J Am Coll Cardiol. 1989 Mar 1;13(3):545-50. doi: 10.1016/0735-1097(89)90590-1.


Doppler echocardiography was used to follow the hemodynamic severity of aortic stenosis. First, the reproducibility of repeat recordings (mean interval 28 +/- 36 days) of aortic jet velocity, made by two independent observers, was tested in 38 adults with aortic stenosis and unchanged clinical status. The two recordings of maximal velocity correlated well (r = 0.96, y = 0.88x + 0.46m/s, SEE = 0.21 m/s) with a mean coefficient of variation of 3.2%. Repeat recording of left ventricular outflow tract velocity by two independent observers in 10 other patients with aortic stenosis also correlated well (r = 0.94, y = 1.06x + 0.0 m/s, SEE = 0.06 m/s) with a mean coefficient of variation of 4.6%. Next, Doppler echocardiography was used to study 42 patients with aortic stenosis (mean age 66 years) over a follow-up interval of 6 to 43 months (mean 20). Maximal aortic jet velocity increased by 0.36 m/s per year (range -0.3 to +1.0 m/s per year). Mean transaortic pressure gradient changed by -7 to +23 (mean 8) mm Hg/year. Aortic valve area by the continuity equation (n = 25) decreased by 0 to 0.5 cm2/year (mean decrease 0.1 cm2/year). Some patients had a worsening of stenosis (decrease in valve area) even though they had no change or a decrease in pressure gradient, because of concurrent decreases in transaortic volume flow. Twenty-one patients (50%) developed new or progressive symptoms of aortic stenosis necessitating valve replacement.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Valve / pathology
  • Aortic Valve Stenosis / physiopathology*
  • Aortic Valve Stenosis / surgery
  • Blood Flow Velocity
  • Echocardiography, Doppler*
  • Female
  • Hemodynamics*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies