Use of the Ejection Fraction-Velocity Ratio in the Hemodynamic Assessment of Aortic Bioprosthetic Valves

Background: A new echocardiographic severity index of aortic valve stenosis has been recently introduced: the ejection fraction‐velocity ratio (EFVR), which is a simple ratio ejection fraction/4Vmax2. This nonflow corrected index demonstrated an excellent accuracy in quantifying the effective orifice area (EOA) in native aortic valves. There is no information about the reliability of EFVR in assessing aortic EOA in patients with bioprostheses. Methods: In 141 consecutive patients with aortic bioprostheses (85 males, mean age 74 ± 9 years), EOA was calculated by both continuity equation (CE) and EFVR. Results: The correlation between CE and EFVR was highly significant (r = 0.88; P < 0.0001). The area under the receiver operating characteristic (ROC) curve was 0.97 (considering a positive case CE < 1.0 cm2, best cutoff of EFVR was