Effective orifice area (EOA) is the standard index for assessing @entity472 ( @entity472 ) severity. However, EOA varies during ejection and a single measurement at 1 ejection time point may not fully describe the hemodynamic severity of a stenotic aortic valve. We investigated whether the dynamic change in EOA during ejection differs between @entity1 with severe @entity472 (EOA </= 1.0 cm(2)) (n = 15) and age-/sex-matched control @entity1 (n = 15), and whether the ejection pattern varies with @entity472 severity (n = 45). In @entity1 with severe @entity472 , maximum left ventricular outflow tract velocity (V(LVOT)) and transvalvular velocity (V( @entity472 )) occurred later in the ejection period (EP) when compared with control @entity1 (V(LVOT) 47 +/- 8 vs 29 +/- 8%, P =.0001; V( @entity472 ) 36 +/- 7 vs 27 +/- 8%, P =.003). Maximum V(LVOT) occurred later than maximum V( @entity472 ) in @entity1 with severe @entity472 (47 +/- 8 vs 36 +/- 7%, P =.0005), but simultaneously in control @entity1 (29 +/- 8 vs 27 +/- 8%, P = NS). @entity1 with severe @entity472 had a slower EOA opening rate than control @entity1 (4 +/- 1 vs 41 +/- 38 cm(2)/s, P =.002) and reached 80% and 100% of maximum EOA later in the EP (43 +/- 26 vs 15 +/- 6%, P =.001; 70 +/- 20 vs 48 +/- 30%, P =.03). EOA tended to increase between 10% and 90% of the EP in @entity1 with severe @entity472 , but had a plateau in control @entity1 (slope 0.38 +/- 0.26 vs 0.02 +/- 0.25% change in EOA per 1% change of EP, P =.0006). In @entity1 with severe @entity472 , EOA was >/=80% of maximum EOA for a shorter duration during ejection compared with control @entity1 (49 +/- 25 vs 64 +/- 14%, P =.05). EOA opening rate, time to maximum V(LVOT), time to maximum V( @entity472 ), and time to 80% of maximum EOA correlated with mean pressure gradient (r = -0.80, 0.63, 0.42, and 0.54, respectively, n = 45). Indices of ejection dynamics and valve kinetics differ in @entity1 with @entity472 and may provide further insight into the hemodynamic or physiologic severity of a stenotic aortic valve.

Temporal variations in effective orifice area during ejection in XXXX with valvular aortic stenosis.

@entity1 :: ('9606', 'Species') :: ['patients', 'Patients'] @entity472 :: ('MESH:D001024', 'Disease') :: ['aortic stenosis', 'AS']
@entity1 :: (9606,Species) :: ['patients']
