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Application of the proximal flow convergence method to calculate the effective regurgitant orifice area in aortic regurgitation

^a Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
^* Section of Biostatistics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA

View larger version (85K): [in a new window]   Figure 1 Example of calculation of the ERO area with the PISA method. Left, Color flow Doppler imaging of the proximal FC recorded from the apical view. Right, Aortic regurgitant jet recorded by continuous wave Doppler echocardiography. R = radius of FC in early diastole.

View larger version (106K): [in a new window]   Figure 2 Flow convergence with an obtuse angle in a patient with aneurysm of the ascending aorta. The position of the aortic leaflets is associated with an obtuse angle of the FC region proximal to the regurgitant orifice (>220°). Ao = aorta; LV = left ventricle.

View larger version (29K): [in a new window]   Figure 3 Correlations between the PISA method and (A) quantitative Doppler echocardiography and (B) two-dimensional echocardiography for calculation of the ERO area. Solid line regression line; gray zone = 95% confidence interval for 59 patients with a flat angle (220°) of the FC region (solid dots). Dashed line = identity line. Open dots superimposed represent the five patients with an obtuse angle of the proximal FC region (>220°).

View larger version (37K): [in a new window]   Figure 4 Scatterplots of the difference (PISA minus reference methods, y-axis) to the reference methods (x-axis) for calculation of ERO using the Doppler echocardiographic method (A) or two-dimensional method (B) as a reference. The patients with appropriate FC are represented by solid dots, and their 95% confidence interval is represented by the gray zone. The differences were not statistically different from zero. The open dots superimposed represent the five patients with an obtuse angle of the proximal FC region (>220°).