ASSESSMENT OF AORTIC REGURGITATION BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY - CORRELATION WITH ANGIOGRAPHIC DETERMINATION

Transthoracic echocardiographic studies have shown that color Doppler mapping of the aortic regurgitation (AR) jet correlated well with the severity of regurgitation as assessed by contrast aortography. The pre sent study was performed to assess whether these parameters could be s imilarly applied to measurements determined by transesophageal echocar diography (TEE). In order to determine and validate criteria for the a ssessment of AR severity, 39 clinically stable patients with a TEE col or Doppler study and contrast aortography within a 2-week period were identified. The ratio of the jet area (JA) to left ventricular diastol ic area (LVDA) had the best correlation to AR severity as determined b y contrast aortography (r = 0.89). Jet length, JA, the ratio of jet wi dth to the width of the left ventricular outflow tract and jet width h ad r values of 0.88, 0.88, 0.83, and 0.84, respectively. The best sens itivity and specificity for the assessment of AR by TEE were obtained as follows: JA/LVDA ratio of 0%-7% predicts 0-1 + AR; 8%-20% 2-3 + AR, and > 20% 4 + AR. Of the three patients miscategorized, none was misg raded by more than one angiographic grade of AR. Jets that measure mor e than 6 cm in length or have an area of > 1 0 cm2 have a 1 00% sensit ivity and specificity for diagnosing 4 + A-R. In the present study the ratio of JA to LVDA area correlates best with AR severity as determin ed by angiography.