{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:33:05Z","timestamp":1740166385777,"version":"3.37.3"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>We aimed to evaluate the efficacy of the measured effective orifice area (EOA)\/reference EOA ratio in discriminating mechanical prosthetic aortic valve (PAV) obstruction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This is a retrospective study of 193 mechanical PAV patients with an elevated mean transprosthetic pressure gradient (PG) over 20 mmHg or peak velocity over 3 m\/s. Of those, 143 patients were objectively proven PAV obstruction with cardiac computed tomography or surgical inspection. The EOA was measured using the continuity equation, and the reference EOA values were obtained from previous guidelines. The measured\/reference EOA ratio was significantly lower in the obstruction group (0.63 \u00b1 0.18 vs. 0.86 \u00b1 0.17; P &amp;lt; 0.001). The EOA ratio added incremental value for discriminating obstruction from the conventional parameters recommended in the guidelines. Receiver operating characteristic curve analysis revealed that the measured\/reference EOA ratio discriminated PAV obstruction from those without obstruction [area under the curve (AUC), 0.840; 95% confidence interval, 0.783\u20130.898; P &amp;lt; 0.001]. A cutoff of 0.71 had 73.4% sensitivity and 82.0% specificity. The novel diagnostic algorithm adding the EOA ratio had similar accuracy to previous guideline algorithms, including reference EOA, and conventional Doppler parameters (AUC, 0.763 vs. 0.731; P = 0.309). In patients with a large PAV (\u226523 mm), the novel algorithm had higher accuracy than the previous algorithm (AUC, 0.788 vs. 0.642; P = 0.019).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The ratio of measured\/reference EOA adds incremental value over conventional Doppler parameters and might be helpful for distinguishing PAV obstruction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac206","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T17:06:09Z","timestamp":1667235969000},"page":"232-240","source":"Crossref","is-referenced-by-count":1,"title":["The ratio of measured and reference effective orifice areas for discriminating prosthetic aortic valve obstruction"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3573-041X","authenticated-orcid":false,"given":"Kyu","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology, Severance Hospital Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 , Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Hospital Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 , Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiwon","family":"Seo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Hospital Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 , Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5927-5410","authenticated-orcid":false,"given":"Iksung","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Hospital Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 , Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi Young","family":"Shim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Hospital Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 , Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4981-3304","authenticated-orcid":false,"given":"Geu-Ru","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Hospital Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 , Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6136-0136","authenticated-orcid":false,"given":"Jong-Won","family":"Ha","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Hospital Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 , Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"2023012300000050800_jeac206-B1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: a population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet"},{"key":"2023012300000050800_jeac206-B2","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1161\/CIRCULATIONAHA.108.778886","article-title":"Prosthetic heart valves: selection of the optimal prosthesis and long-term management","volume":"119","author":"Pibarot","year":"2009","journal-title":"Circulation"},{"key":"2023012300000050800_jeac206-B3","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/S0735-1097(10)80178-0","article-title":"Obstruction of mechanical heart valve prostheses: clinical aspects and surgical management","volume":"17","author":"Deviri","year":"1991","journal-title":"J Am Coll Cardiol"},{"key":"2023012300000050800_jeac206-B4","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1136\/heartjnl-2011-300351","article-title":"Doppler echocardiographic evaluation of prosthetic valve function","volume":"98","author":"Pibarot","year":"2012","journal-title":"Heart"},{"key":"2023012300000050800_jeac206-B5","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1161\/01.CIR.73.3.452","article-title":"Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography","volume":"73","author":"Zoghbi","year":"1986","journal-title":"Circulation"},{"key":"2023012300000050800_jeac206-B6","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1161\/01.CIR.83.1.213","article-title":"Doppler echocardiographic assessment of the st. 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