Quantitative evaluation of aortic insufficiency by continuous wave Doppler echocardiography.

To assess the usefulness of continuous wave Doppler echocardiography in the evaluation of aortic insufficiency, the aortic regurgitant flow velocity pattern obtained with continuous wave Doppler examination was compared with the results of aortography and conventional pulsed Doppler techniques in 25 individuals with aortic insufficiency. The diastolic deceleration slope as measured from the continuous wave tracing was significantly different among subgroups of patients with mild (1.6 +/- 0.5 m/s2), moderate (2.7 +/- 0.5 m/s2) and severe (4.7 +/- 1.5 m/s2) aortic insufficiency as determined from aortography. Deceleration slopes greater than 2 m/s2 separated individuals with moderate and severe insufficiency from those with mild insufficiency. Similar findings were seen when comparing the pressure half-time method of diastolic velocity decay with the more severe grades of aortic insufficiency exhibiting the shortest pressure half-times. There was also a high correlation (r = 0.85) between the deceleration slope measured by continuous wave Doppler recordings and the grade of insufficiency as assessed by pulsed Doppler echocardiography. End-diastolic velocities correlated poorly (r = 0.28) with catheter-measured end-diastolic pressure difference between the aorta and the left ventricle. These findings demonstrate that the aortic regurgitant flow pattern by continuous wave Doppler echocardiography may be useful in quantitating the degree of aortic insufficiency by assessing the rate with which aortic and left ventricular pressures equilibrate during diastole.

[1]  A. Labovitz,et al.  Doppler hemodynamic evaluation of prosthetic (Starr-Edwards and Björk-Shiley) and bioprosthetic (Hancock and Carpentier-Edwards) cardiac valves. , 1985, The American journal of cardiology.

[2]  A. Nitenberg,et al.  Assessment and follow-up of patients with aortic regurgitation by an updated Doppler echocardiographic measurement of the regurgitant fraction in the aortic arch. , 1985, Circulation.

[3]  A. Benchimol,et al.  Doppler ultrasound in cardiology: Physical principles and clinical applications , 1982 .

[4]  J. Tanouchi,et al.  A new approach to noninvasive evaluation of aortic regurgitant fraction by two-dimensional Doppler echocardiography. , 1985, Circulation.

[5]  M. Winniford,et al.  Limitations of qualitative angiographic grading in aortic or mitral regurgitation. , 1984, The American journal of cardiology.

[6]  R. Bonow,et al.  Observations on the optimum time for operative intervention for aortic regurgitation. II. Serial echocardiographic evaluation of asymptomatic patients. , 1980, Circulation.

[7]  S. Goldberg,et al.  Quantitative assessment by Doppler echocardiography of pulmonary or aortic regurgitation. , 1985, The American journal of cardiology.

[8]  D. Kalmanson,et al.  Non-invasive diagnosis and assessment of aortic valve disease and evaluation of aortic prosthesis function using echo pulsed Doppler velocimetry. , 1980, British heart journal.

[9]  A. Pearlman,et al.  Noninvasive detection of aortic insufficiency in patients with mitral stenosis by pulsed Doppler echocardiography. , 1985, Journal of the American College of Cardiology.

[10]  D. Boughner.  Assessment of Aortic Insufficiency by Transcutaneous Doppler Ultrasound , 1975, Circulation.

[11]  William Grossman,et al.  Cardiac catheterization and angiography , 1974 .

[12]  Calculation of pulsed Doppler left ventricular outflow tract regurgitant index for grading the severity of aortic regurgitation. , 1984, American heart journal.

[13]  L. Hatle,et al.  Doppler ultrasound in cardiology , 1985 .

[14]  M. Turina,et al.  Improved late survival in patients with chronic aortic regurgitation by earlier operation. , 1984, Circulation.

[15]  H. Kennedy,et al.  Prosthetic mitral regurgitation detected by Doppler echocardiography. , 1985, The American journal of cardiology.

[16]  R. Okada,et al.  Exercise testing in aortic regurgitation: comparison of radionuclide left ventricular ejection fraction with exercise performance at the anaerobic threshold and peak exercise. , 1983, The American journal of cardiology.

[17]  Michael V. Green,et al.  Reversal of left ventricular dysfunction after aortic valve replacement for chronic aortic regurgitation: influence of duration of preoperative left ventricular dysfunction. , 1984, Circulation.

[18]  V. M. Jelinek.  Serial M‐mode Echocardiography in Severe Chronic Aortic Regurgitation , 1980, Circulation.

[19]  L Hatle,et al.  Noninvasive Assessment of Atrioventricular Pressure Half‐time by Doppler Ultrasound , 1979, Circulation.

[20]  R. Miller,et al.  Assessment of pulsed Doppler echocardiography in detection and quantification of aortic and mitral regurgitation. , 1980, British heart journal.

[21]  D. Kalmanson,et al.  New indexes for assessing aortic regurgitation with two-dimensional Doppler echocardiographic measurement of the regurgitant aortic valvular area. , 1983, Circulation.

[22]  A S Abbasi,et al.  Pulsed Doppler echocardiography in the diagnosis and estimation of severity of aortic insufficiency. , 1982, The American journal of cardiology.