Author + information
- Received September 17, 1985
- Revision received November 19, 1985
- Accepted November 22, 1985
- Published online April 1, 1986.
- Philip J. Currie, MBBS, FRACPa,b,
- Donald J. Hagler, MD, FACC,
- James B. Seward, MD, FACC,
- Guy S. Reeder, MD, FACC,
- Derek A. Fyfe, MD, PhD,
- Alfred A. Bove, MD, PhD, FACC and
- A. Jamil Taji, MD, FACC
- ↵aAddress for reprints: Philip J. Currie, MD, Department of Cardiology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44106.
To more precisely measure the beat to beat and instantaneous pressure gradients across outflow stenotic lesions, simultaneous Doppler and dual catheter pressure gradient measurements were performed in 95 patients (mean age 42 years, range 1.5 to 85). There were 38 right ventricular and 62 left ventricular outflow obstructive lesions. Forty-nine patients also had a nonsimultaneous Doppler study performed within 7 days before catheterization. The simultaneous pressure waveforms and Doppler spectral velocity profiles were digitized at 10 ms intervals deriving maximal, mean and instantaneous gradients (mm Hg).
For simultaneous maximal Doppler and catheter gradient measurements, the correlation coefficient (r) was 0.95 (SEE = 10mm Hg), for Doppler and catheter mean gradients it was 0.94 (SEE = 8 mm Hg) and for maximal Doppler and peak to peak catheter gradients it was 0.92 (SEE = 13 mm Hg). The correlation of maximal and mean Doppler gradients with the respective catheter gradients was similarly high when the right and left ventricular outflow lesions were analyzed separately. However, the maximal Doppler gradient was significantly higiter than the peak to peak catheter gradient. This was more evident with left ventricular outflow stenotic lesions. The correlation of the outpatient maximal Doppler and catheter gradients (r = 0.80, SEE = 17 mm Hg) was significantly lower than the simultaneous correlation (r = 0.96, SEE =10 mm Hg) in the 49 patients with two Doppler studies.
Continuous wave Doppler echocardiography accurately measures the instantaneous pressure gradient across both left and right ventricular outflow obstructive lesions. The maximal Doppler gradient should not be equated with the peak to peak catheter gradient. As Doppler echocardiography measures instantaneous pressure gradients, it should not be directly compared with nonsimultaneous events.
- Received September 17, 1985.
- Revision received November 19, 1985.
- Accepted November 22, 1985.
- American College of Cardiology Foundation