An integrated approach to the quantification of aortic regurgitation by Doppler echocardiography

Background Although different Doppler methods have been proposed for the qu antification of aortic regurgitation, no study has prospectively compared t hese methods with each other and their correlation with angiography. The ai m of this study was to prospectively analyze the usefulness of different Do ppler echocardiography parameters by testing all such parameters in each pa tient. Methods Fifty-one patients with aortic regurgitation underwent 2-dimensiona l and Doppler echocardiographic studies and catheterization. The following Doppler indexes were analyzed and compared with aortography. Color Doppler: (1) jet color height/left ventricular outflow tract height in parasternal long-axis view, and (2) let color area/left ventricular outflow tract area in short-axis view. Continuous Doppler: (3) regurgitant flow pressure half- time, (4) regurgitant flow time velocity integral (in centimeters), and (5) regurgitant flow time velocity integral (in centimeters)/diastolic period (in milliseconds). Pulsed Doppler in thoracic and abdominal aorta: (6) rime velocity integral of diastolic reverse flow (in centimeters), (7) time vel ocity integral of systolic anterograde flow/integral of diastolic reverse f low, (8) (time velocity integral of diastolic reverse flow/diastolic period ) x 100, and (9) diastolic reverse flow duration/diastolic period (as a per centage). We compared these parameters with severity of: regurgitation meas ured by angiography and classified as mild, moderate, or severe. Results The most useful parameters were (1) jet color height/left ventricul ar outflow tract height (correctly classified 42 of 49 patients), (2) (time velocity integral of diastolic reverse flow/diastolic period) x 100 in the thoracic aorta (correctly classified 41 of 46 patients), and (3) (time vel ocity integral of diastolic reverse flow/diastotic period) x 100 in the abd ominal aorta (correctly classified 42 of 49 patients). Sequential integrati on of these 3 parameters correctly classified 96% of patients (44 of 46 pat ients) and was achieved in 90% of cases. Conclusion An integrated combination of several Doppler parameters can quic kly and accurately classify the degree of aortic regurgitation as determine d by angiography.