Aortic flow velocity patterns in chronic aortic regurgitation: implications for Doppler echocardiography.

S. C. Reimold, S. E. Maier, K. Aggarwal, K. E. Fleischmann, D. Piwnica-Worms, R. Kikinis, R. T. Lee

Research output: Contribution to journalArticle

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Abstract

Aortic regurgitation is associated with retrograde diastolic flow in the aorta. Echocardiographic quantitative analysis of the magnitude of the flow reversal is believed to provide an estimate of severity of regurgitant disease despite variations in flow profiles. The purpose of this study was to evaluate the uniformity of flow patterns in the aorta of patients with aortic regurgitation and to investigate the relationship between these profiles and the echocardiographic estimates of flow reversal. Seventeen patients with chronic aortic regurgitation underwent cine-phase magnetic resonance imaging in an axial section through the ascending and descending aorta. The regurgitant fraction in the ascending aorta 4 cm above the aortic valve and the descending aorta were calculated from the velocity maps. These results were compared with data from nine individual sample volumes in the ascending and descending aorta. The magnetic resonance ascending aortic regurgitant fraction was compared with Doppler echocardiographic descending aortic flow velocity patterns. The descending aortic regurgitant fraction correlated only weakly with the ascending aortic regurgitant fraction (descending aortic regurgitant fraction = 0.62% ascending aortic regurgitant fraction + 0.04%; r = 0.75; p < 0.001). Regurgitant proportions in all sample volumes in the descending aorta, but not in the ascending aorta, were significantly related to the ascending aortic regurgitant fraction. The best descending aortic Doppler echocardiographic parameter for predicting ascending aortic regurgitant fraction was the end-diastolic velocity (end-diastolic velocity = 32.2 cm/sec. ascending aortic regurgitant fraction + 1.4 cm/sec; r = 0.94; p < 0.001). Pulsedwave Doppler sampling of descending aortic flow reflects severity of aortic regurgitant disease, in part the result of more uniform blood-velocity profiles in the descending aorta compared with the ascending aorta. The Doppler end-diastolic velocity in the descending aorta is a useful parameter of severity of aortic regurgitation.

Original languageEnglish (US)
Pages (from-to)675-683
Number of pages9
JournalJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
Volume9
Issue number5
StatePublished - Sep 1996

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Aortic Valve Insufficiency
Doppler Echocardiography
Aorta
Thoracic Aorta
Cine Magnetic Resonance Imaging
Aortic Diseases
Aortic Valve
Magnetic Resonance Spectroscopy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Aortic flow velocity patterns in chronic aortic regurgitation : implications for Doppler echocardiography. / Reimold, S. C.; Maier, S. E.; Aggarwal, K.; Fleischmann, K. E.; Piwnica-Worms, D.; Kikinis, R.; Lee, R. T.

In: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, Vol. 9, No. 5, 09.1996, p. 675-683.

Research output: Contribution to journalArticle

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abstract = "Aortic regurgitation is associated with retrograde diastolic flow in the aorta. Echocardiographic quantitative analysis of the magnitude of the flow reversal is believed to provide an estimate of severity of regurgitant disease despite variations in flow profiles. The purpose of this study was to evaluate the uniformity of flow patterns in the aorta of patients with aortic regurgitation and to investigate the relationship between these profiles and the echocardiographic estimates of flow reversal. Seventeen patients with chronic aortic regurgitation underwent cine-phase magnetic resonance imaging in an axial section through the ascending and descending aorta. The regurgitant fraction in the ascending aorta 4 cm above the aortic valve and the descending aorta were calculated from the velocity maps. These results were compared with data from nine individual sample volumes in the ascending and descending aorta. The magnetic resonance ascending aortic regurgitant fraction was compared with Doppler echocardiographic descending aortic flow velocity patterns. The descending aortic regurgitant fraction correlated only weakly with the ascending aortic regurgitant fraction (descending aortic regurgitant fraction = 0.62{\%} ascending aortic regurgitant fraction + 0.04{\%}; r = 0.75; p < 0.001). Regurgitant proportions in all sample volumes in the descending aorta, but not in the ascending aorta, were significantly related to the ascending aortic regurgitant fraction. The best descending aortic Doppler echocardiographic parameter for predicting ascending aortic regurgitant fraction was the end-diastolic velocity (end-diastolic velocity = 32.2 cm/sec. ascending aortic regurgitant fraction + 1.4 cm/sec; r = 0.94; p < 0.001). Pulsedwave Doppler sampling of descending aortic flow reflects severity of aortic regurgitant disease, in part the result of more uniform blood-velocity profiles in the descending aorta compared with the ascending aorta. The Doppler end-diastolic velocity in the descending aorta is a useful parameter of severity of aortic regurgitation.",
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