A new method to calculate aortic valve area without left heart catheterization.

Warth, David C.; Stewart, William J.; Block, P C; Weyman, A E

doi:10.1161/01.cir.70.6.978

Cited by 69 publications

(15 citation statements)

References 18 publications

(4 reference statements)

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“…The maximum instantaneous catheter gradient was always higher than the peak-to-peak gradient over a wide range of severity of aortic stenosis (figure 4), with a close correlation between the maximum and peak-to-peak gradients (r = .95, SEE 11 mm Hg) (figure 5). The linear regression equation relating these gradients was Peak-to-peak gradient = 0.84 X maximum gradient 13 FIGURE 5. Correlation of the maximum catheter pressure gradient with the peak-to-peak catheter gradient in the 100 patients.…”

Section: Resultsmentioning

confidence: 99%

“…The lower correlation between the nonsimultaneous and simultaneous Doppler-catheter pressure measurements in the 46 patients in our study is believed to represent the effect of time elapsed between the studies and differences in hemodynamic state. In previous reports1'I 13 with fluid-filled catheters.8'-3 The use of high-fidelity transducer-tipped catheters may circumvent some of these problems. A closer Doppler-pressure correlation was shown in studies of experimental aortic stenosis in dogs'5 and in patients with aortic stenosis16 when transducer-tipped rather than fluid-filled catheters were used for pressure recording.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Continuous-wave Doppler echocardiographic assessment of severity of calcific aortic stenosis: a simultaneous Doppler-catheter correlative study in 100 adult patients.

Currie¹,

Seward²,

Reeder³

et al. 1985

Circulation

483

140

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Continuous-wave Doppler echocardiographic assessment of severity of calcific aortic stenosis: a simultaneous Doppler-catheter correlative study in 100 adult patients.

Currie¹,

Seward²,

Reeder³

et al. 1985

Circulation

483

140

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“…More recently, aortic valve area was quantitated with the use of Doppler velocities combined with flow measurements obtained at right heart catheterization. 12 Laminar flow through a conduit is equal to the mean velocity times the cross-sectional area of the orifice. With flow remaining constant, the ratio of cross-sectional areas at two different sites is inversely propor-tional to the ratio of the respective mean velocities (figure 1).…”

mentioning

confidence: 99%

Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography.

Zoghbi¹,

Farmer²,

Soto³

et al. 1986

Circulation

358

120

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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 crosssectional 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- No. 3, 452-459, 1986. ACCURATE ASSESSMENT of the hemodynamic severity of aortic stenosis from clinical and echocardiographic findings is frequently difficult, particularly in the elderly patient. ' -4 Recently, several studies have demonstrated a good correlation between aortic valve gradients measured at cardiac catheterization and gradients estimated by continuous-wave Doppler echocardiography and a modification of the Bernoulli equation.5-9 However, the pressure gradient through a stenotic valve is largely dependent on flow, which in turn depends on left ventricular performance and the presence of concomittant valvular regurgitation.

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“…Use of Doppler ultrasound to calculate aortic valve area without left heart catherization has recently been reported in a similar group of adult patients [ 5 ] , but the technique described was not completely noninvasive, since the flow across the valve was obtained as a standard thermodilution cardiac output.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive determination of valve area in adults with aortic stenosis using doppler echocardiography

Holmvang

McConville

Tomlinson

1986

Cathet. Cardiovasc. Diagn.

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Doppler ultrasound has been used to determine the pressure gradient P1-P2 across the valve in patients with aortic stenosis (AS), but since the gradient varies over time and may be deceptively low in patients with impaired cardiac output, the key parameter to obtain is the orifice area (A). By calculating stroke volume (SV) from the modal flow velocity [Vmode(t)] over the systolic ejection period (sep) or diastolic filling period (dfp), wherever laminar flow exists in the heart across an area of known diameter D, (pulmonary artery or atrioventricular valves), and by substituting P1-P2 = 4Vmax2, (Vmax = peak velocity in the aortic jet), the Gorlin formula becomes: (Formula: see text) where theta = flow intercept angle at D. This approach was applied in nine adult patients with AS (age 64 +/- 8 years) in whom recent catheterization data was available for comparison. Close correlation was found between the calculated areas: A(Doppler) = 0.82 A(Cath) + 0.17 (r = 0.94, p less than 0.001). Two patients with Doppler gradients of less than 40 mmHg were shown by this Doppler method nevertheless to have severely narrowed orifice areas of less than or equal to 0.78 cm2. Although there is a tendency to overestimate slightly the valve area, Doppler ultrasound assessment using this technique adds valuable noninvasive information concerning the degree of aortic valve disease.

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A new method to calculate aortic valve area without left heart catheterization.

Cited by 69 publications

References 18 publications

Continuous-wave Doppler echocardiographic assessment of severity of calcific aortic stenosis: a simultaneous Doppler-catheter correlative study in 100 adult patients.

Continuous-wave Doppler echocardiographic assessment of severity of calcific aortic stenosis: a simultaneous Doppler-catheter correlative study in 100 adult patients.

Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography.

Noninvasive determination of valve area in adults with aortic stenosis using doppler echocardiography

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