APPLICATION OF COLOR DOPPLER FLOW MAPPING TO CALCULATE EFFECTIVE REGURGITANT ORIFICE AREA - AN IN-VITRO STUDY AND INITIAL CLINICAL OBSERVATIONS

被引:170
作者
VANDERVOORT, PM
RIVERA, JM
MELE, D
PALACIOS, IF
DINSMORE, RE
WEYMAN, AE
LEVINE, RA
THOMAS, JD
机构
[1] MASSACHUSETTS GEN HOSP, NONINVAS CARDIAC LAB, BOSTON, MA 02114 USA
[2] MASSACHUSETTS GEN HOSP, CARDIAC CATHETERIZAT LAB, CARDIAC UNIT, BOSTON, MA 02114 USA
[3] MASSACHUSETTS GEN HOSP, DEPT MED, BOSTON, MA 02114 USA
[4] MASSACHUSETTS GEN HOSP, DEPT RADIOL, BOSTON, MA 02114 USA
关键词
ECHOCARDIOGRAPHY; DOPPLER; VALVULAR REGURGITATION;
D O I
10.1161/01.CIR.88.3.1150
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Analogous to stenotic valve area in the assessment of valvular stenosis, regurgitant orifice area (ROA) represents a fundamental parameter to assess valvular insufficiency. However, this parameter has not been routinely available up to now. In this study, we introduce the concept and provide the methodology to calculate regurgitant orifice area noninvasively, based on the analysis of the proximal flow convergence zone. Methods and Results. In an in vitro study, we showed the feasibility and the accuracy of calculating effective ROA by the proximal flow convergence method throughout a range of driving pressures. The calculated and true ROA showed an excellent correlation with r=.992, DELTAROA= -1.4+/-2.9 mm2. We then applied this concept clinically in 77 patients with mitral regurgitation and showed a very good correlation between effective ROA calculated by the proximal How convergence method and calculated by the Doppler echocardiographic method: r=.95, DELTAROA=-0.2+/-3.9 mm2. The ROA also correlated very well with Doppler echocardiographic-derived regurgitant stroke volume (r=.93) and regurgitant fraction (r=.82). In a subgroup of 20 patients who underwent invasive evaluation, the calculated effective ROA also correlated well with the angiographic grade of mitral regurgitation (rho=.81). Conclusion. We conclude that effective ROA represents unique information on the severity of a regurgitant lesion and can easily be calculated by the proximal flow convergence method. This new parameter should enhance our understanding and improve the serial assessment of valvular regurgitation.
引用
收藏
页码:1150 / 1156
页数:7
相关论文
共 28 条
  • [1] ECHOCARDIOGRAPHIC EVALUATION OF MITRAL-VALVE STRUCTURE AND FUNCTION IN PATIENTS FOLLOWED FOR AT LEAST 6 MONTHS AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY
    ABASCAL, VM
    WILKINS, GT
    CHOONG, CY
    THOMAS, JD
    PALACIOS, IF
    BLOCK, PC
    WEYMAN, AE
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1988, 12 (03) : 606 - 615
  • [2] A DOPPLER-2-DIMENSIONAL ECHOCARDIOGRAPHIC METHOD FOR QUANTITATION OF MITRAL REGURGITATION
    ASCAH, KJ
    STEWART, WJ
    LENG, JA
    GUERRERO, JL
    NEWELL, JB
    GILLAM, LD
    WEYMAN, AE
    [J]. CIRCULATION, 1985, 72 (02) : 377 - 383
  • [3] A NEW METHOD FOR QUANTITATION OF MITRAL REGURGITATION BASED ON COLOR FLOW DOPPLER IMAGING OF FLOW CONVERGENCE PROXIMAL TO REGURGITANT ORIFICE
    BARGIGGIA, GS
    TRONCONI, L
    SAHN, DJ
    RECUSANI, F
    RAISARO, A
    DESERVI, S
    VALDESCRUZ, LM
    MONTEMARTINI, C
    [J]. CIRCULATION, 1991, 84 (04) : 1481 - 1489
  • [4] ANGIOCARDIOGRAPHIC EVALUATION OF VALVULAR INSUFFICIENCY
    BARON, MG
    [J]. CIRCULATION, 1971, 43 (04) : 599 - &
  • [5] A NEW METHOD FOR NONINVASIVE QUANTIFICATION OF VALVULAR REGURGITATION BASED ON CONSERVATION OF MOMENTUM - INVITRO VALIDATION
    CAPE, EG
    SKOUFIS, EG
    WEYMAN, AE
    YOGANATHAN, AP
    LEVINE, RA
    [J]. CIRCULATION, 1989, 79 (06) : 1343 - 1353
  • [6] IMPACT OF IMPINGING WALL JET ON COLOR DOPPLER QUANTIFICATION OF MITRAL REGURGITATION
    CHEN, CG
    THOMAS, JD
    ANCONINA, J
    HARRIGAN, P
    MUELLER, L
    PICARD, MH
    LEVINE, RA
    WEYMAN, AE
    [J]. CIRCULATION, 1991, 84 (02) : 712 - 720
  • [7] CHEN CG, 1992, CIRCULATION, V86, P805
  • [8] LIMITATIONS OF QUALITATIVE ANGIOGRAPHIC GRADING IN AORTIC OR MITRAL REGURGITATION
    CROFT, CH
    LIPSCOMB, K
    MATHIS, K
    FIRTH, BG
    NICOD, P
    TILTON, G
    WINNIFORD, MD
    HILLIS, LD
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1984, 53 (11) : 1593 - 1598
  • [9] AN ANGIOCARDIOGRAPHIC METHOD FOR DIRECTLY DETERMINING LEFT VENTRICULAR STROKE VOLUME IN MAN
    DODGE, HT
    HAY, RE
    SANDLER, H
    [J]. CIRCULATION RESEARCH, 1962, 11 (04) : 739 - &
  • [10] THE MITRAL-VALVE ORIFICE METHOD FOR NON-INVASIVE TWO-DIMENSIONAL ECHO DOPPLER DETERMINATIONS OF CARDIAC-OUTPUT
    FISHER, DC
    SAHN, DJ
    FRIEDMAN, MJ
    LARSON, D
    VALDESCRUZ, LM
    HOROWITZ, S
    GOLDBERG, SJ
    ALLEN, HD
    [J]. CIRCULATION, 1983, 67 (04) : 872 - 877