This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2005.05.076v3 46/6/1045    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tan, J.-L. Articles by Li, W. Search for Related Content PubMed PubMed Citation Articles by Tan, J.-L. Articles by Li, W.

CARDIAC ULTRASOUND

Doppler Echocardiographic Profile and Indexes in the Evaluation of Aortic Coarctation in Patients Before and After Stenting

Ju-Le Tan, MBBS, MRCP^_*,, Sonya V. Babu-Narayan, MBBS, MRCP^_*, Michael Y. Henein, MD, PhD, Michael Mullen, MD, MRCP^_* and Wei Li, MD, PhD^_*,,_*

^_* Adult Congenital Heart Disease Unit, Royal Brompton Hospital, London, United Kingdom
Department of Echocardiography, Royal Brompton Hospital, London, United Kingdom
National Heart Center, Singapore General Hospital, Singapore

Manuscript received February 1, 2005; revised manuscript received May 17, 2005, accepted May 31, 2005.

^_* Reprint requests and correspondence: Dr. Wei Li, Department of Echocardiography, Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom (Email: w.li{at}rbht.nhs.uk).

OBJECTIVES: We sought to assess the effect of successful stenting on the Doppler profile of aortic coarctation and to identify echocardiographic indexes that could be used for follow-up of such patients.

BACKGROUND: Doppler echocardiography demonstrates characteristic flow patterns in significant aortic coarctation.

METHODS: We undertook retrospective echocardiographic analyses before and at six to nine months after coarctation stenting in consecutive patients from 2002 to 2003. Peak systolic pressure gradient (SPG), diastolic velocity (DV), end-diastolic tail velocity (EDTV), systolic velocity half-time index (SVHTi) and diastolic velocity half-time index (DVHTi), and systolic pressure half-time index (SPHTi) and diastolic pressure half-time index (DPHTi) were measured. The severity of aortic coarctation was compared with cardiovascular magnetic resonance (CMR) imaging using the coarctation index (CoAi).

RESULTS: The patient cohort was divided into two groups: group 1 (13 patients; age 30 ± 8 years), which consisted of patients with significant aortic coarctation treated with stenting, and group 2 (11 patients; age 39 ± 16 years), which consisted of patients with previous surgical repair of aortic coarctation without evidence of re-coarctation. After stenting, there was significant reduction in SPG (p = 0.001), DV (p = 0.001), EDTV (p = 0.005), DVHTi (p = 0.001), and DPHTi (p = 0.001) values. In the patient group as a whole, there was a significant correlation between SPG and DV (r = 0.86; p < 0.001), EDTV (r = 0.80; p < 0.001), DVHTi (r = 0.56; p < 0.001), and DPHTi (r = 0.50; p = 0.002). In addition, DV >193 cm/s (100% sensitivity, 100% specificity) and diastolic/systolic velocity ratio >0.53 (100% sensitivity, 96% specificity) had high predictive values for severe aortic coarctation (CoAi <0.25).

CONCLUSIONS: After stenting, peak SPG, DV, and pressure half-time indexes (i.e., DVHTi and DPHTi) decreased significantly. These findings can confidently be used in the follow-up of coarctation patients after stenting, particularly in those with limited two-dimensional images.

Abbreviations and Acronyms   CMR = cardiovascular magnetic resonance   CoAi = coarctation index   DPHTi = diastolic pressure half-time index   DT = diastolic tail   DV = diastolic velocity   DVHTi = diastolic velocity half-time index   EDTV = end-diastolic tail velocity   SPG = systolic pressure gradient   SPHTi = systolic pressure half-time index   SV = systolic velocity   SVHTi = systolic velocity half-time index

This article has been cited by other articles:

				Y.-Y. Lam, M. G Kaya, W. Li, V. S Mahadevan, A. A Khan, M. Y Henein, and M. Mullen Effect of endovascular stenting of aortic coarctation on biventricular function in adults Heart, November 1, 2007; 93(11): 1441 - 1447. [Abstract] [Full Text] [PDF]

				W. Li, K. H. Parker, and M. Henein Reply J. Am. Coll. Cardiol., July 18, 2006; 48(2): 419 - 420. [Full Text] [PDF]

				C. DeGroff Doppler Echocardiographic Profile and Indexes J. Am. Coll. Cardiol., July 18, 2006; 48(2): 419 - 419. [Full Text] [PDF]