Accuracy of combined two-dimensional echocardiography and continuous wave Doppler recordings in the estimation of pressure gradient in right ventricular outlet obstruction

Fifteen patients (median age 8.5 years) with fixed right ventricular outflow tract obstruction were evaluated by two-dimensional echocardiographically directed continuous wave Doppler ultrasound within 24 hours of cardiac catheterization. Pulmonary artery blood velocity measurements were determined...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1984-04, Vol.3 (4), p.1013-1018
Main Authors: Johnson, Gregory L., Kwan, Oi Ling, Handshoe, Sharon, Noonan, Jacqueline A., DeMaria, Anthony N.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Blood Flow Velocity
Blood Pressure
Cardiology. Vascular system
Child
Child, Preschool
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Echocardiography - methods
Heart
Heart Septal Defects, Ventricular - physiopathology
Humans
Infant
Medical sciences
Pulmonary Circulation
Pulmonary Valve Stenosis - physiopathology
Ultrasonography
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Summary:Fifteen patients (median age 8.5 years) with fixed right ventricular outflow tract obstruction were evaluated by two-dimensional echocardiographically directed continuous wave Doppler ultrasound within 24 hours of cardiac catheterization. Pulmonary artery blood velocity measurements were determined from a real time spectral display of pulmonary artery flow profile and converted to pressure drop utilizing a modified Bernoulli equation. Use of both parasternal and subcostal imaging permitted more accurate detection of maximal flow velocity than did use of either approach alone. Gradients estimated from Doppler recordings correlated well with those measured at cardiac catheterization (correlation coefficient= 0.95, standard error of the estimate = 7.9 mm Hg) with a trend to slight underestimation of gradient in more severe obstruction. In three patients with combined valvular and subvalvular stenosis and one patient with right ventricular outlet obstruction due totally to a ventricular septal aneurysm, Doppler estimation of gradient provided an accurate assessment of total right ventricular-pulmonary artery gradient. Thus, continuous wave Doppler ultrasound combined with two-dimensional echocardiography provides a reliable noninvasive method of estimating pressure gradient in patients with right ventricular outflow tract obstruction.
ISSN:0735-1097
1558-3597
DOI:10.1016/S0735-1097(84)80361-7