Author + information
- Received December 23, 1985
- Revision received April 8, 1986
- Accepted April 17, 1986
- Published online September 1, 1986.
- Steve M. Teague, MD, FACC*,‡,
- James A. Heinsimer, MD†,
- Jerome L. Anderson, MD*,
- Kevin Sublett, MD*,
- Edwin G. Olson, MD*,
- Wyatt F. Voyles, MD, FACC* and
- Udho Thadani, MD, FACC*
- ↵‡Address for reprints: Steve M. Teague, MD, 3E204, University of Oklahoma Health Sciences Center, Box 26901, Oklahoma City, Oklahoma 73190.
Aortic regurgitation and mitral stenosis are hemody-namically similar, insofar as both result in passive ventricular filling across a narrow orifice driven by a declining pressure gradient. Because mitral stenosis is successfully characterized by Doppler ultrasound determination of the velocity half-time, or time constant, aortic regurgitation might be quantified in an analogous fashion. Eighty-six patients with diverse causes of aortic regurgitation underwent continuous wave Doppler examination before cardiac catheterization or urgent aortic valve replacement. The Doppler velocity half-time was defined as the time required for the diastolic aortic regurgitation velocity profile to decay by 29%, whereas catheterization pressure half-time was calculated as the time required for transvalvular pressure to decay by 50%.
Doppler velocity and catheterization pressure half-times were linearly related (r = 0.91). Doppler velocity half-times were inversely related to regurgitant fraction (r = −0.88). Angiographic severity (1+ = mild to 4 + = severe) was also inversely related to pressure and velocity half-time; a Doppler half-time threshold of 400 ms separated mild (1 +, 2 +) from significant (3 +, 4 +) aortic regurgitation with high specificity (0.92) and predictive value (0.90). The Doppler velocity half-time was independent of pulse pressure, mean arterial pressure, ejection fraction and left ventricular end-diastolic pressure. Estimation of transvalvular aortic pressure half-time utilizing continuous wave Doppler ultrasound is a reliable and accurate method for the noninvasive evaluation of the severity of aortic regurgitation.
- Received December 23, 1985.
- Revision received April 8, 1986.
- Accepted April 17, 1986.
- American College of Cardiology Foundation