Comparison of high pulse repetition frequency and continuous wave doppler echocardiography for velocity measurement and gradient prediction in children with valvular and congenital heart disease

• Published in: Journal of the American College of Cardiology 1986-04, Vol.7 (4), p.873-879
• Main Authors: Snider, A. Rebecca, Stevenson, J. Geoffrey, French, James W., Rocchini, Albert P., Dick, Macdonald, Rosenthal, Amnon, Crowley, Dennis C., Beekman, Robert H., Peters, Jane
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Blood Flow Velocity; Cardiac Catheterization; Cardiovascular system; Child; Child, Preschool; Echocardiography - methods; Female; Heart Defects, Congenital - physiopathology; Heart Valve Diseases - physiopathology; Hemodynamics; Humans; Infant; Infant, Newborn; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Pressure; Ultrasonic investigative techniques
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(86)80350-3

To compare the ability of high pulse repetition frequency and continuous wave Doppler echocardiography to detect the peak velocity of a jet flow disturbance and to predict pressure gradients accurately, two groups of children with valvular or congenital heart disease were examined using both Doppler techniques. The use study group included 84 children or adolescents (aged 1 day to 19 years) who underwent examination in the echocardiography laboratory with both Doppler techniques in a randomized sequence. The peak velocity recorded with high pulse repetition frequency Doppler echocardiography was compared with the peak velocity recorded with the continuous wave technique. The accuracy study group included 41 children or adolescents (aged 1 day to 16 years) who underwent examination with both Doppler techniques at the time of cardiac catheterization. Doppler pressure gradients were calculated from the peak velocity using the simplified Bernoulli equation and were compared with peak instantaneous gradients and peak to peak gradients measured at catheterization. In the use study, a high correlation was found between peak velocities detected by high pulse repetition frequency and continuous wave Doppler echocardiography (r = 0.94, SEE = 0.28 m/s). In the accuracy study, close correlations were found between measured peak to peak pressure gradients and pressure gradients calculated from continuous wave (r = 0.95, SEE = 7.9 mm Hg) and high pulse repetition frequency Doppler echocardiography (r = 0.94, SEE = 8.7 mm Hg). Also, close correlations were found between measured peak instantaneous gradients and pressure gradients calculated from continuous wave (r = 0.96, SEE = 7.1 mm Hg) and high pulse repetition frequency Doppier echocardiography (r = 0.95, SEE = 7.5 mm Hg). Thus, in children and adolescents, no difference was found in the ability of the two Doppler techniques to detect the peak velocity of a jet flow disturbance. Both Doppler techniques were equally accurate in their ability to predict pressure gradients measured at cardiac catheterization.