Echocardiographic Assessment of the Aortic Stenosis Valve Area: Parameters and Outcome

Background: Among individuals who have a stenotic aortic valve, a precise assessment of aortic valve area is essential for clinical judgment. So far, no studies have been conducted to investigate and assess the role of the three dimensional echo-cardiography in the assessment of the valve stenosis. This study aims to compare and assess the precision of the measurement of the stenosis area of the aortic valve by 2D versus 3D echo-cardiography. Method: This was a cross-sectional study conducted in Baghdad Medical City, Ministry of Health in Iraq from the 1st December 2021 to the 1st June 2022. Aortic valve area was calculated in a cross-sectional study by using transthoracic echo-Doppler, continuity equation, and 3D and 3D/2D planimetr. Results: 33 patients with aortic stenosis were examined. AVA analysis of correlation and absolute agreement revealed the agreement was high and the absolute differences were minimal across all planimetric methods: 3D vs. 3D/2D: 0.913 (0.829–0.957); 2D vs. 3D/2D: 0.747 (0.537–0.869). For AVA evaluation, the correlation coefficient r between 3D and 2D was (0.902) and (0.729), respectively. The observer variability was equal for all approaches, while the 3D inter-observer variability was higher than for 2D techniques (p = 0.036). Conclusion: The 3D/2D echo techniques for AVA planimetry agreed with the traditional 2D methodology and flow-derived methods. When compared with 2D AVA on the principle of continuity equation, the 3D approach was at least as excellent as the 2D method and had a greater repeatability. Using 3D Echo in the evaluation of aortic valve area is a not-invasive procedure leading to the AS quantitative assessment that is accurate and reliable.