TY - JOUR
T1 - Evaluation of aortic regurgitation with digitally determined color Doppler-imaged flow convergence acceleration
T2 - A quantitative study in sheep
AU - Shiota, Takahiro
AU - Jones, Michael
AU - Yamada, Izumi
AU - Heinrich, Russell S.
AU - Ishii, Masahiro
AU - Sinclair, Brian
AU - Yoganathan, Ajit P.
AU - Sahn, David J.
N1 - Funding Information:
The development of Doppler echocardiographic techniques has enhanced the noninvasive assessment of aortic regurgitation (1-10). However, most of the Doppler echocardiographic methods for grading the severity of aortic regurgitation have been compared with cineangiographic grading of the severity of aortic regurgitation, radionuclide scintigraphy or other Doppler flow observations. The severity of aortic regurgitation estimated by cineaortography depends on many factors and may differ substantially from results of quantitative flow measurements (11,12). Recently Giesler et al. (13,14) and we From the Oregon Health SciencesU niversity, Portland, Oregon; the *National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; and the tGeorgia Institute of Technology,A tlanta, Georgia. This work was supported in part by Grant HL43287f rom the National Heart, Lung, and Blood Institute.
PY - 1996/1
Y1 - 1996/1
N2 - Objectives. The aim of the present study was to validate a digital color Doppler-based centerline velocity/distance acceleration profile method for evaluating the severity of aortic regurgitation. Background. Clinical and in vivo experimental applications of the flow convergence axial centerline velocity/distance profile method have recently been used to estimate regurgitant flow rates and regurgitant volumes in the presence of mitral regurgitation. Methods. In six sheep, a total of 19 hemodynamic states were obtained pharmacologically 14 weeks after the original operation in which a portion of the aortic noncoronary (n = 3) or right coronary (n = 3) leaflet was excised to produce aortic regurgitation. Echocardiographic studies were performed to obtain complete proximal axial how acceleration velocity/distance profiles during the time of peak regurgitant flow (usually early in diastole) for each hemodynamic state. For each steady state, the severity of aortic regurgitation was assessed by measurement of the magnitude of the regurgitant flow volume/beat, regurgitant fraction and instantaneous regurgitant flow rates determined by using both aortic and pulmonary artery electromagnetic how probes. Results. Grade I regurgitation (regurgitant volume/beat <15 ml, six conditions), grade II regurgitation (regurgitant volume/beat between 16 ml and 30 ml, five conditions) and grade III-IV regurgitation (regurgitant volume/beat >30 ml, eight conditions) were clearly separated by using the color Doppler centerline velocity/distance profile domain technique. Additionally, an equation for correlating 'a' (the coefficient from the multiplicative curve fit for the velocity/distance relation) with the peak regurgitant flow rates (Q [liters/min]) was derived shelving a high correlation between calculated peak flow rates by the color Doppler method and the actual peak flow rates (Q = 13a + 1.0, r = 0.95, p < 0.0001, SEE = 0.76 liters/min). Conclusions. This study, using quantified aortic regurgitation, demonstrates that the flow convergence axial centerline velocity/distance acceleration profile method can be used to evaluate the severity of aortic regurgitation.
AB - Objectives. The aim of the present study was to validate a digital color Doppler-based centerline velocity/distance acceleration profile method for evaluating the severity of aortic regurgitation. Background. Clinical and in vivo experimental applications of the flow convergence axial centerline velocity/distance profile method have recently been used to estimate regurgitant flow rates and regurgitant volumes in the presence of mitral regurgitation. Methods. In six sheep, a total of 19 hemodynamic states were obtained pharmacologically 14 weeks after the original operation in which a portion of the aortic noncoronary (n = 3) or right coronary (n = 3) leaflet was excised to produce aortic regurgitation. Echocardiographic studies were performed to obtain complete proximal axial how acceleration velocity/distance profiles during the time of peak regurgitant flow (usually early in diastole) for each hemodynamic state. For each steady state, the severity of aortic regurgitation was assessed by measurement of the magnitude of the regurgitant flow volume/beat, regurgitant fraction and instantaneous regurgitant flow rates determined by using both aortic and pulmonary artery electromagnetic how probes. Results. Grade I regurgitation (regurgitant volume/beat <15 ml, six conditions), grade II regurgitation (regurgitant volume/beat between 16 ml and 30 ml, five conditions) and grade III-IV regurgitation (regurgitant volume/beat >30 ml, eight conditions) were clearly separated by using the color Doppler centerline velocity/distance profile domain technique. Additionally, an equation for correlating 'a' (the coefficient from the multiplicative curve fit for the velocity/distance relation) with the peak regurgitant flow rates (Q [liters/min]) was derived shelving a high correlation between calculated peak flow rates by the color Doppler method and the actual peak flow rates (Q = 13a + 1.0, r = 0.95, p < 0.0001, SEE = 0.76 liters/min). Conclusions. This study, using quantified aortic regurgitation, demonstrates that the flow convergence axial centerline velocity/distance acceleration profile method can be used to evaluate the severity of aortic regurgitation.
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U2 - 10.1016/0735-1097(95)00392-4
DO - 10.1016/0735-1097(95)00392-4
M3 - Article
C2 - 8522696
AN - SCOPUS:0030058332
SN - 0735-1097
VL - 27
SP - 203
EP - 210
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 1
ER -