Conference Proceeding - Restricted Access
Journal of the American College of Cardiology
Discordance is the discrepancy and often overestimation of the echocardiography-derived transaortic mean gradient (MG) compared with direct invasive measurement. It has been reported in aortic stenosis (AS) and post–transcatheter aortic valve replacement (TAVR). Pressure recovery (PR) has been proposed to explain this discordance
We included patients with severe AS presenting for TAVR. Invasive MG (IMG) at the level of the aortic valve (A), midascending aorta (B), ascending aorta and aortic arch junction (C), and aortic arch and descending aorta (D) junction was obtained using standardized invasive hemodynamics with 2 pigtails. Echocardiographic and IMG were compared at points A, B, C, and D pre- and post-TAVR. The aortic valve area (AVA) and noninvasive MG were obtained by echocardiography, and the AAA was obtained
Twenty-five patients were included. Pre-TAVR, there was no difference between echocardiography and IMG at level A (P = 0.49) and B (P = 0.06). However, echocardiography overestimated IMG at C (P = 0.004) and D (P = 0.0008). There was no difference between the discordance between echocardiography and IMG at level D and NIPR (P = 0.18) (Figure). Post-TAVR, echocardiography overestimated IMG at level A, B, C, and D (P < 0.05). There was a difference between the discordance at level D and NIPR (P =
In severe AS, discordance between echocardiography and IMG is explained by PR. However, post-TAVR, discordance is not simply explained by PR.
Madanat L, Schott J, Mando R, Hanson I, Renard B, Fazzalari F, et al. [Abbas A]. Is discordance between echocardiography and invasive transaortic valve mean gradients related to pressure recovery? J Am Coll Cardiol. 2022 Sep 20;80(12 Suppl):B147-B148. doi:10.1016/j.jacc.2022.08.430.