REAPPRAISAL OF QUANTITATIVE-EVALUATION OF PULMONARY REGURGITATION ANDESTIMATION OF PULMONARY-ARTERY PRESSURE BY CONTINUOUS-WAVE DOPPLER-ECHOCARDIOGRAPHY

This study assessed the usefulness of continuous wave Doppler echocard iography and color flow mapping in evaluating pulmonary regurgitation (PR) and estimating pulmonary artery (PA) pressure. Forty-three patien ts were examined, and high quality Doppler spectral recordings of PR w ere obtained in 32. All patients underwent cardiac catheterization, an d simultaneous PA and right ventricular (RV) pressures were recorded i n 17. Four Doppler regurgitant flow velocity patterns were observed: p andiastolic plateau, biphasic, peak and plateau, and early diastolic t riangular types. The peak diastolic and end-diastolic PA-to-RV pressur e gradients derived from the Doppler flow profiles correlated well wit h the catheter measurements (r = 0.95 and r = 0.95, respectively). As PA pressure increased, the PR flow velocity became higher; a linear re lationship between either systolic or mean PA pressure and Doppler-der ived peak diastolic pressure gradient was noted (r = 0.90 and 0.94, re spectively). Based on peak diastolic gradients of <15, 15-30 or >30 mm Kg, patients could be separated as those with mild, moderate or sever e pulmonary hypertension, respectively (p < 0.05). A correlation was a lso observed between PA diastolic pressure and Doppler-derived end-dia stolic pressure gradient (r = 0.91). Moreover, the Doppler velocity de cay slope of PR closely correlated with that derived from the catheter method (r = 0.98). The decay slope tended to be steeper with the incr ement in regurgitant jet area and length obtained from color flow mapp ing. In conclusion, continuous wave Doppler evaluation of PR is a usef ul means for noninvasive estimation of PA pressure, and the Doppler ve locity decay slope seems to reflect the severity of PR.