Evaluation of aortic insufficiency by Doppler color flow mapping

• Published in: Journal of the American College of Cardiology Vol. 9; no. 4; pp. 952 - 959
• Main Authors: Perry, Gilbert J., Helmcke, Frederick, Nanda, Navin C., Byard, Christopher, Soto, Benigno
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1987; Elsevier Science
• Subjects: Adult; Aged; Aortic Valve Insufficiency - classification; Aortic Valve Insufficiency - diagnosis; Aortic Valve Insufficiency - diagnostic imaging; Aortography; Biological and medical sciences; Cardiology. Vascular system; Cineangiography; Color; Diatrizoate Meglumine; Echocardiography - methods; Endocardial and cardiac valvular diseases; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Doppler ultrasound study; Human; Dyes; Flow rate; Cardiac valvular disease; Ultrasonic investigation; Cardiovascular disease; Aortic regurgitation
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(87)80254-1

The color Doppler echocardiographic studies and aortic angiograms of all patients who had these procedures performed within 2 weeks of each other between October 1984 and August 1985 were reviewed to determine whether any parameters of the regurgitant jet visualized by color Doppler study predicted the severity of aortic insufficiency as assessed by angiographic grading. Patients with an aortic valve prosthesis were excluded. Twenty-nine patients had aortic insufficiency and had adequate color Doppler studies for analysis. The mean time between color Doppler examination and angiography was 2.3 days (range 0 to 12). The maximal length and area of the regurgitant jet were poorly predictive of the angiographic grade of aortic insufficiency. The short-axis area of the regurgitant jet from the parasternal short-axis view at the level of the high left ventricular outflow tract relative to the short-axis area of the left ventricular outflow tract at the same location best predicted angiographic grade, correctly classifying 23 of 24 patients. However, the jet could be seen from this view in only 24 of the 29 patients. The height of the regurgitant jet relative to left ventricular outflow tract height measured from the parasternal long-axis view just beneath the aortic valve correctly classified 23 of the 29 patients. Mitral stenosis or valve prosthesis, which was present in 10 patients, did not interfere with the diagnosis or quantitation of aortic insufficiency by these methods. The thickness of the regurgitant stream at its origin relative to the size of the left ventricular outflow tract is a better predictor of the severity of aortic insufficiency as judged by angiographic grading than is the area of the regurgitant jet or the depth to which the jet extends in the left ventricle.