Correlation of echo-Doppler aortic valve regurgitation index with angiographic aortic regurgitation severity.
ABSTRACT We assessed aortic regurgitation (AR) severity by utilizing multiple echo-Doppler variables in comparison with AR severity by aortic root angiography. Patients were divided into 3 groups: mild, moderate, and severe. An AR index (ARI) was developed, comprising 5 echocardiographic parameters: ratio of color AR jet height to left ventricular outlet flow diameter, AR signal density from continuous-wave Doppler, pressure half-time, left ventricular end-diastolic diameter, and aortic root diameter. There was a strong correlation between AR severity by angiography and the calculated echo-Doppler ARI (r = 0.84, p = 0.0001). As validated by aortic angiography, the ARI is an accurate reflection of AR severity.
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ABSTRACT: Although different Doppler methods have been proposed for the quantification of aortic regurgitation, no study has prospectively compared these methods with each other and their correlation with angiography. The aim of this study was to prospectively analyze the usefulness of different Doppler echocardiography parameters by testing all such parameters in each patient. Fifty-one patients with aortic regurgitation underwent 2-dimensional and Doppler echocardiographic studies and catheterization. The following Doppler indexes were analyzed and compared with aortography. Color Doppler: (1) jet color height/left ventricular outflow tract height in parasternal long-axis view, and (2) jet color area/left ventricular outflow tract area in short-axis view. Continuous Doppler: (3) regurgitant flow pressure half-time, (4) regurgitant flow time velocity integral (in centimeters), and (5) regurgitant flow time velocity integral (in centimeters)/diastolic period (in milliseconds). Pulsed Doppler in thoracic and abdominal aorta: (6) time velocity integral of diastolic reverse flow (in centimeters), (7) time velocity integral of systolic anterograde flow/integral of diastolic reverse flow, (8) (time velocity integral of diastolic reverse flow/diastolic period) x 100, and (9) diastolic reverse flow duration/diastolic period (as a percentage). We compared these parameters with severity of regurgitation measured by angiography and classified as mild, moderate, or severe. The most useful parameters were (1) jet color height/left ventricular outflow tract height (correctly classified 42 of 49 patients), (2) (time velocity integral of diastolic reverse flow/diastolic period) x 100 in the thoracic aorta (correctly classified 41 of 46 patients), and (3) (time velocity integral of diastolic reverse flow/diastolic period) x 100 in the abdominal aorta (correctly classified 42 of 49 patients). Sequential integration of these 3 parameters correctly classified 96% of patients (44 of 46 patients) and was achieved in 90% of cases. An integrated combination of several Doppler parameters can quickly and accurately classify the degree of aortic regurgitation as determined by angiography.American Heart Journal 01/1999; 136(6):1030-41. · 4.50 Impact Factor
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ABSTRACT: Visual estimates of the intensity of the regurgitant signal (RS) obtained by continuous-wave (CW) Doppler has been used as an indicator of the severity of aortic regurgitation (AR). This study was designed to test this concept quantitatively using digital image processing methods. Twenty-one patients with AR were studied, 14 of whom had concomitant mitral valve disease. Patients with aortic stenosis were excluded. By angiography, 10 patients had mild (grade 1 or 2), 5 had moderate (grade 3), and 6 severe (grade 4) AR. We digitized three well-defined AR envelopes and calculated the mean pixel intensity (MPI) of the RS and the systolic flow signal (SFS) using an offline computer analysis system developed in our laboratory. To negate the effects of different gain settings, the ratio of RS to SFS (RS/SFS ratio) was compared to angiographic grade of AR. Thus, each patient served as his own control. The mean RS/SFS ratio was 0.54 +/- 0.42 SD (range 0.46-0.59) for mild AR, 0.76 +/- 0.71 SD (range 0.65-0.82) for moderate AR, and 0.84 +/- 0.52 (range 0.77-0.92) for severe AR. This RS/SFS ratio correlated well with angiographic severity of AR (r = 0.9). A ratio of <0.6 identified patients with mild AR and >0.6 correlated with moderate-to-severe AR. We conclude that the ratio of the regurgitant to systolic flow CW Doppler signal is an accurate noninvasive indicator of AR severity. (ECHOCARDIOGRAPHY, Volume 13, May 1996)Echocardiography 06/1996; 13(3):259-264. · 1.26 Impact Factor