Original Articles
A Study of Echocardiographic Indices in subjects with Degenerative Aortic Valve Disease | |
Dr. Ritesh Kumar Banode, Dr. Ratnesh Nandkishor Rokade, Dr. Deepti Chand | |
Background: While the elderly constituted only 24 million in 1961, the 2001 census has shown that the elderly population of India accounted for 77 million. As there is no Indian study available on DAVD in Indian population, the purpose of this is to study the various echocardiographic indices in DAVD in Indian study subjects and its Association with various cardiovascular risk factors. Materials & methods:A total of 78 cases of Degenerative aortic valve disease having ejection systolic murmur (ESM) at aortic area from OPD and IPD were studied. A detailed clinical history was taken of all the patients who were included in the study with special attention to risk factor identification, Patients were specifically asked about history regarding dyspnoea, angina and syncopal attacks. Clinical information concerning age, gender, systemic hypertension, coronary artery disease, cerebrovascular episode, cigarette smoking, and diabetes mellitus were noted for each patient. Two-dimensional assessment of the aortic valve was performed on the basis of the parasternal long-axis and short-axis views. Degenerative aortic valve disease was characterized by an abnormal irregular thickening or a focal or diffuse increase of the echogenicity of the leaflets with or without reduced systolic opening. All Doppler echocardiographic recordings were registered with 100 mm/s and performed in expiration. Results:Total number of 78 subjects was studied out of which 56 were male and 22 were female. The mean age of the total study subjects was 71.09 yrs. Group A includes 38 (48.7%) subject and group B includes 40(51.3%) subjects. Subjects of Group A and B was further divided into two groups on the basis of presence or absence of regional wall motion abnormality (RWMA). Group A had 13(34.21%) subjects with RWMA and group B had 18(45%) subjects with RWMA. The mean value of IVS and PW in aortic stenosis group was 13.5 ±1.60 and 12.5 ± 1.53 and aortic sclerosis group was11.39±1.22 and 10.47±1.08 respectively. The difference between the group for IVS and PW was statistically significant (P<0.0001). The Mean gradient in group A was 6.46±2.23 mm/Hg and group B was 23.07 ±14.81 mm/Hg and the difference difference between two groups were statistically significant (p <0.001). The aortic valve area in group A was 3.45 ± 0.27cm2 and Group B was 1.54 ±0.5 cm2 and the difference difference between two groups were statistically significant (p <0.001). Statistically significant effect was demonstrated for Age, BMI, hypertension and Smoking. Conclusion:Thus we may conclude that measurement of Aortic valve area by continuity equation should be a part of routine evaluation of the aortic valve before deciding the management strategies in a given case. |
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