DOPPLER EVALUATION OF AORTIC REGURGITATION IN CHILDREN

Doppler indexes have been used successfully to determine the severity of aortic regurgitation (AR) in adults but have not been evaluated sys tematically in children. To evaluate the accuracy of specific Doppler echocardiographic indexes in assessing the degree of AR in children, 3 0 children underwent 2-dimensional and Doppler echocardiography within 24 hours of angiography. Patients were divided into 4 groups based on the degree of angiographic AR. Color Doppler jet width, short-axis le t area, let length, and maximum let area were measured AR slope was me asured using continuous-wave Doppler. Flow in the abdominal aorta was evaluated using pulsed Doppler. Doppler indexes were compared with the angiographic grade of AR. Jet width and short-axis significantly diff erent between groups and showed strong correlation with the angiograph ic grade. Holodiastolic flow reversal in the abdominal aorta separated 1+ to 2+ from 3+ to 4+ AR (100% sensitivity and 100% negative predict ive value for 3+ to 4+ AR). Jet length, maximum jet area, and the rati o of reverse to forward abdominal aortic velocity time integrals corre lated with angiography but showed little difference between groups tha t differed by only 1 angiographic grade. AR slope did not correlate wi th the angiographic grade. We conclude that in children, color Doppler jet width, short-axis let area, and holodiastolic abdominal aortic fl ow reversal are the best predictors of angiographic severity. Use of t hese indexes may obviate the need for angiography to determine the deg ree of AR in children. (C) 1997 by Excerpta Medica, Inc.