GOPALARAO NEMANA, M.D.
To the editor: I read with interest the article "Echocardiographic Estimation of Aortic-Valve Gradient in Aortic Stenosis" in the September issue (1).
It is surprising that the authors have chosen to include four patients who were found to have no gradient across the aortic valve on left heart catheterization. Even if the condition is clinically suspected, absence of gradient across the aortic valve eliminates the diagnosis. This error, I presume, will not add the same statistical significance that the authors claim.
The paper is based on the assumption that normal left ventricle maintains a constant wall stress when faced with
NEMANA G. Aortic Stenosis and Echocardiography. Ann Intern Med. ;90:439. doi: 10.7326/0003-4819-90-3-439_1
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Published: Ann Intern Med. 1979;90(3):439.
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