Consistency analysis for large LVOTd ≥2.3 cm (mean 2.40±0.13)
| Less than severe AS by AVA | Severe AS by AVA | ||||
|---|---|---|---|---|---|
| Consistent grading AVA ≥cut-off MG ≤40 Vmax ≤4 | Inconsistent grading AVA ≥cut-off MG >40 Vmax >4 | Inconsistency | Consistent grading AVA <cut-off MG >40 Vmax >4 | Inconsistent grading AVA <cut-off MG ≤40 Vmax ≤4 | Inconsistency |
| AVA cut-off 1 cm2 | |||||
| n=1970 | n=282 | Total inconsistency 13% | n=691 | n=131 | Total inconsistency 16% |
| SVI 52±10 (SVI ≤35=2%) | SVI 58±11* (SVI ≥58=45%) | (Inconsistency with SVI ≤58=7%) | SVI 48±8 | SVI 41±7* (SVI ≤35=20%) | (Inconsistency with SVI ≥35=13%) |
| AVA cut-off 0.9 cm2 | |||||
| n=2052 | n=521 | Total inconsistency 20% | n=452 | n=49 | Total inconsistency 10% |
| SVI 52±10 (SVI ≤35=3%) | SVI 54±10* (SVI ≥58=30%) | (Inconsistency with SVI ≤58=14%) | SVI 46±8 | SVI 38±6* (SVI ≤35=35%) | (Inconsistency with SVI ≥35=6%) |
| AVA cut-off 0.8 cm2 | |||||
| n=2087 | n=752 | Total inconsistency 27% | n=221 | n=14 | Total inconsistency 6% |
| SVI 51±10 (SVI ≤35=3%) | SVI 53±10* (SVI ≥58=23%) | (Inconsistency with SVI ≤58=20%) | SVI 44±8 | SVI 36±7* (SVI ≤35=57%) | (Inconsistency with SVI ≥35=3%) |
*p Value <0.006 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 large 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.