Relation between Doppler color flow variables and invasively determined jet variables in patients with aortic regurgitation
SC Reimold,
JD Thomas,
and
RT Lee
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115.
OBJECTIVES. The purpose of this study was to test the hypothesis that invasively derived jet variables including regurgitant orifice area and momentum determine the characteristics of Doppler color flow jets in patients with aortic regurgitation. BACKGROUND. In vitro studies have demonstrated that the velocity distribution of a regurgitant jet is best characterized by the momentum of the jet, which incorporates orifice area and velocity of flow through the orifice. METHODS. Peak jet momentum, peak flow rate and regurgitant orifice area were determined with intraaortic Doppler catheter and cardiac catheterization techniques in 22 patients with chronic aortic regurgitation. These invasively derived variables were compared with apical and parasternal long-axis Doppler color echocardiographic variables obtained in the catheterization laboratory. RESULTS. Jet momentum increased significantly with the angiographic grade of regurgitation. The apical color jet area of aortic regurgitation increased linearly with jet momentum and regurgitant orifice area in vivo, but the correlations were only moderately good (r = 0.63 and 0.65, respectively). Color jet length also increased linearly with jet momentum and with regurgitant orifice area. There was only a trend for Doppler color jet width to increase with all invasively derived jet variables. CONCLUSIONS. Whereas jet area by Doppler color flow imaging is directly related to both orifice area and jet momentum in vivo, Doppler color variables measured in planes normal to the orifice do not correlate well enough with either jet momentum or regurgitant orifice area to predict jet flow variables in patients with aortic regurgitation. It is likely that the important influence of adjacent boundaries will limit the use of the velocity distribution of aortic regurgitant jets for determining the severity of disease.
