Circulation, Vol 71, 1162-1169, Copyright © 1985 by American Heart Association
PJ Currie, JB Seward, GS Reeder, RE Vlietstra, DR Bresnahan, JF Bresnahan, HC Smith, DJ Hagler and AJ Tajik
Studies of the correlation of aortic valve gradient determined by
continuous-wave Doppler echocardiography and that determined at
catheterization have, to date, involved young patients and nonsimultaneous
measurements. We therefore obtained simultaneous Doppler echocardiographic
and catheter measurements of pressure gradient in 100 consecutive adults
(mean age 69, range 50 to 89 years). In 63 patients pressure measurements
were obtained with dual-catheter techniques and in 37 they were obtained by
withdrawal of the catheter from the left ventricle to the ascending aorta.
Forty-six of these patients also underwent an outpatient Doppler study 7
days or less before catheterization. The simultaneous pressure waveforms
and Doppler spectral velocity profiles were digitized at 10 msec intervals
and maximum, mean, and instantaneous gradients (mm Hg) were derived for
each. The correlation between the Doppler-determined gradient and the
simultaneously measured maximum catheter gradient was r = .92 (SEE = 15 mm
Hg), that between the Doppler-determined and mean catheter gradient was r =
.93 (SEE = 10 mm Hg), and that between the Doppler and peak-to- peak
catheter gradient was r = .91 (SEE = 14). The correlation between the
nonsimultaneously Doppler-determined gradient and the maximum gradient
measured by catheter was not as strong (r = .79, SEE = 24). The
continuous-wave Doppler echocardiographic velocity profile represents the
instantaneous transaortic pressure gradient throughout the cardiac cycle.
The best correlation with continuous-wave Doppler- determined gradient was
obtained with maximum and mean gradients measured by catheter.
Continuous-wave Doppler echocardiography can be used to reliably predict
the pressure gradient in adults with calcific aortic stenosis.
ARTICLES
Continuous-wave Doppler echocardiographic assessment of severity of calcific aortic stenosis: a simultaneous Doppler-catheter correlative study in 100 adult patients
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