Table 3

Consistency analysis for small LVOTd 1.7–1.9 cm (mean 1.87±0.05)

Less than severe AS by AVASevere AS by AVA
Consistent grading AVA ≥cut-off MG ≤40 Vmax ≤4Inconsistent grading AVA ≥cut-off MG >40 Vmax >4InconsistencyConsistent grading AVA <cut-off MG >40 Vmax >4Inconsistent grading AVA <cut-off MG ≤40 Vmax ≤4Inconsistency
AVA cut-off 1 cm2
 n=268n=7Total inconsistency 3% n=288n=269Total inconsistency 48%
 SVI 50±9 (SVI ≤35=3%)SVI 59±8* (SVI ≥58=57%)(Inconsistency with SVI ≤58=1%)SVI 43±9SVI 41±8* (SVI ≤35=21%)(Inconsistency with SVI ≥35=38%)
AVA cut-off 0.9 cm2
 n=370n=18Total inconsistency 5%n=277n=167Total inconsistency 38%
 SVI 48±9 (SVI ≤35=5%)SVI 58±9* (SVI ≥58=56%)(Inconsistency with SVI ≤58=2%)SVI 43±9SVI 39±8* (SVI ≤35=27%)(Inconsistency with SVI ≥35=28%)
AVA cut-off 0.8 cm2
 n=447n=38Total inconsistency 8%n=257n=90Total inconsistency 26%
 SVI 47±9 (SVI ≤35=7%)SVI 55±10* (SVI ≥58=37%)(Inconsistency with SVI ≤58=5%)SVI 42±8SVI 37±8* (SVI ≤35=37%)(Inconsistency with SVI ≥35=16%)
  • *p Value <0.02 compared with consistent grading SVI for each AVA cut-off.

  • AVA (cm2), MG (mm Hg), Vmax (m/s), SVI (ml/m2).

  • The ‘consistent grading’ and ‘inconsistent grading’ category columns contain the absolute number of patients assigned to that category, their stroke volume index and the percentage of patients with low flow (SVI ≤35 ml/m2) and high flow (SVI ≥58 ml/m2). The ‘inconsistency’ columns contain the total inconsistency and the remaining inconsistency with normal flow in parenthesis. All columns have been divided in three rows according to different AVA cut-offs for the small LVOTd group. The first row contains the patient category assignment under current guidelines. The second and third rows show the category reassignment of patients when cut-offs of 0.9 cm2 and 0.8 cm2 are used, respectively.

  • AS, aortic stenosis; AVA, aortic valve area; LVOTd, left ventricular outflow tract diameter; MG, mean gradient; SVI, stroke volume index.