Comparison of 3 methods for assessing AS in patients with AF v.1
Research type
Research Study
Full title
Method comparison study to assess the agreement between and repeatability of three different methods for measuring the aortic valve area in patients with aortic stenosis and atrial fibrillation by comparison with patients with aortic stenosis and sinus rhythm – a pilot study.
IRAS ID
176948
Contact name
Lois Albin
Contact email
Duration of Study in the UK
1 years, 10 months, 1 days
Research summary
Title: Method comparison study to assess the agreement between and repeatability of three different methods for measuring the aortic valve area in patients with aortic stenosis and atrial fibrillation by comparison with patients with aortic stenosis and sinus rhythm – a pilot study.
Summary:
Aortic stenosis is narrowing of the aortic valve(1). Aortic valve area (AVA) is measured to help assess how narrow the aortic valve is(2). Atrial fibrillation (AF) causes the heart to beat irregularly(3), making it more difficult to measure the aortic valve area(2).
To reduce error associated with AF, the AVA is measured using two different pressure measurements that have each been averaged over ≥ 5 heart beats(2). However, one must question whether obtaining averaged pressure measurements are sufficient to ensure that the two different pressure measurements are similar to each other, a requirement of the AVA equation(4).
AVA is an important measurement that should be performed in every patient with AS(2) and is used alongside other echocardiographic measurements to guide the timing of AV replacement surgery(5). However, there is a lack of scientific evidence to support the recommended AVA measurement method in patients with AS and AF.
This study will assess the agreement between the recommended AVA measurement method and two novel AVA measurement methods, which take into consideration the irregular heart rhythm of patients in AF and the 3D shape of the heart.
The data collected from this study will also allow us to gain greater insight into the AS disease process in patients with regular and irregular heart beats.
This study has the potential to improve the standard of practice for the assessment of AS in AF.
This is a prospective clinical investigation study. Patients with AS who attend the University Hospital of North Durham for their echocardiograms may voluntarily participate. Participants will undergo a standard echocardiogram plus a small number of additional echocardiographic images.
References:
(1) Tidy, C. (2012) Aortic stenosis. Available at: http://www.patient.co.uk/health/aortic-stenosis-leaflet (Accessed 15/03/2015).
(2) Baumgartner, H., Hung, J., Bermejo, J., et al. (2009) ‘Echocardiographic assessment of valve stenosis: EAE/ASE recomnmendations for clinical practice’, European Journal of Echocardiography, 10, pp. 1-25.
(3) Mayo Foundation for Medical Education and Research (2015) Diseases and conditions: Atrial fibrillation. Available at: http://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/basics/definition/con-20027014 (Accessed 15/03/2015).
(4) Murphy, J.G., Lloyd, M.A. (2012) Mayo Clinic Cardiology: Concise Textbook. Fourth edition. Oxford: Oxford University Press.
(5) Vahanian, A., Alfieri, O., Andreotti, F., et al. (2012) ‘Guidelines in the management of valvular heart disease (version 2012)’, European Heart Journal, 33, pp. 2451-2496.REC name
West of Scotland REC 5
REC reference
15/WS/0139
Date of REC Opinion
1 Jul 2015
REC opinion
Favourable Opinion