Assessment of aortic valvular stenosis from the aortic pressure pulse.

In a search for an indirect estimate of severity, data from 40 patients with pure aortic stenosis have been analyzed. Calculated aortic valvular areas ranged from 0.5 cm2 to 2.4 cm.2 Both aortic systolic upstroke time and the rate of aortic pressure rise were significantly altered by aortic stenosis; neither permitted reliable estimates of severity of the stenosis. An estimate of arterial compliance, stroke volume divided by pulse pressure, has been used in conjunction with the first derivative of rising aortic pressure to obtain an index of aortic stenosis. This index correlates well with calculated aortic valvular area (r = 0.912) and permits estimates of the severity of aortic stenosis when the left ventricle cannot be entered.