Color-guided Doppler echocardiographic assessment of aortic valve stenosis

Department of Medicine, University of Alabama, Birmingham 35294.

The severity of valvular aortic stenosis was assessed by Doppler color flow mapping in 100 consecutive patients who underwent successful cardiac catheterization within 2 weeks of the Doppler study. The maximal width of the aortic stenosis jet seen in 61 of these patients (Group A) was measured at the aortic valve. Color-guided continuous wave Doppler examination was used to measure the mean transaortic pressure gradient, and the aortic valve area was estimated using the simplified continuity equation. The aortic stenosis jet was not seen in 39 patients (Group B), and the mean pressure gradient and aortic valve area in these patients were assessed by conventional Doppler echocardiography alone. The mean pressure gradient obtained by continuous wave Doppler study and cardiac catheterization in the 61 Group A patients correlated well (r = 0.90); the correlation was lower in the 39 Group B patients (r = 0.70). The overall correlation for the combined Groups A and B was good (r = 0.82). The aortic valve area estimated by continuous wave Doppler study and cardiac catheterization in 54 Group A patients correlated well (r = 0.92); the correlation in 22 Group B patients was lower (r = 0.71). The correlation for all 76 patients (Groups A and B) was good (r = 0.80). The maximal aortic stenosis jet width also correlated well with the aortic valve area estimated at catheterization in 54 patients (r = 0.90). Group C represented an additional 14 patients in whom the left ventricle could not be entered during cardiac catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)