Circulation, Vol 73, 452-459, Copyright © 1986 by American Heart Association
WA Zoghbi, KL Farmer, JG Soto, JG Nelson and MA Quinones
Laminar flow through a conduit is equal to the mean velocity times the
cross-sectional area of the orifice. Therefore, volume is equal to the
time-velocity integral multiplied by the cross-sectional area. In aortic
stenosis, flow in the stenotic jet is laminar and the aortic valve area
should be equal to the volume of blood ejected through the valve divided by
the time-velocity integral of the aortic jet velocity recorded by
continuous-wave Doppler echocardiography. To test whether this concept can
be used to accurately determine aortic valve area noninvasively by the
Doppler method, 39 patients (age 35 to 82 years, mean 63) underwent pulsed
Doppler combined with two-dimensional echocardiography for measurement of
stroke volume at the aortic, pulmonic, and mitral anulus as well as
continuous-wave Doppler recording of the aortic jet. Aortic valve area
determined at cardiac catheterization by the Gorlin equation ranged between
0.4 and 2.07 cm2 (mean 0.89 +/- 0.45). Doppler-derived valve area,
determined with the stroke volume value from either the aortic, pulmonic,
or mitral anulus, correlated well with the area determined at cardiac
catheterization (r = .95, .97, and .96, respectively). A simplified method
for measuring aortic valve area derived as the cross-sectional area of the
aortic anulus times peak velocity just proximal to the aortic valve divided
by peak aortic jet velocity correlated well with measurements obtained at
cardiac catheterization (r = .94). An excellent separation between critical
and noncritical aortic stenosis was seen using either one of the Doppler
methods.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography
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