[Correlation between aortic transvalvular gradient obtained with Doppler ultrasonography and with hemodynamics study. Role of the underlying etiology].

In aortic stenosis, a good correlation was found between the gradients obtained by catheterization and Echo-Doppler. However, the correlation of these two methods in subgroups of patients with different etiologies of aortic stenosis is unknown. The aim of this study was to evaluate, whether the correlation between catheterization and Echo-Doppler was similar in patients with different etiologies of aortic stenosis. Patients with concomitant valvular disease were excluded. Only patients with a clearly defined etiology (based on clinical history, echocardiography, angiography and/or pathology) were included in this study. We evaluated 106 patients with aortic stenosis. Forty-nine patients had degenerative aortic stenosis, 32 bicuspid aortic stenosis and 25 rheumatic aortic stenosis. The percentage of male patients in each group were as follows: 57.1% in the denerative aortic group; 62.5% in the bicuspid aortic stenosis group; and 76% in the rheumatic aortic stenosis group. Mean age (years) was 69 +/- 6.7 in the degenerative aortic stenosis group, 58.1 +/- 7.5 in the bicuspid aortic stenosis group, and 64 +/- 7.1 in the rheumatic aortic stenosis group. In our study we found different correlations between the gradients obtained by the two methods-catheterization and Eco-Doppler-among the patients with different etiologies of aortic stenosis. The correlation coefficient (r2) was 0.54 (p < 0.001) in the rheumatic aortic stenosis group, 0.37 (p < 0.001) in the bicuspid aortic stenosis group and 0.21 (p = 0.001) in the degenerative aortic stenosis group. In conclusion, a good overall correlation was found between the two methods in aortic stenosis, however, this correlation is different in the three etiologies of aortic stenosis. The correlation is better in rheumatic valves, intermediate in bicuspid valves, and worse in degenerative valves. Changes in aortic valve morphology in these subgroups of patients are probably responsible for these different results.