Pivotal role of aortic valve area calculation by the continuity equation for Doppler assessment of aortic stenosis in patients with combined aortic stenosis and regurgitation.


Journal Article

Aortic regurgitation (AR) may result in overestimation of the aortic pressure gradient by continuous wave Doppler in patients with mixed aortic valve disease. However, few data are available regarding the effect of AR on noninvasive estimates of aortic valve area by the continuity equation. Therefore, 25 patients with angiographically documented severe AR and peak systolic aortic velocities of greater than 2.5 m/s were studied by continuous wave Doppler to determine the accuracy of pressure gradient and aortic valve area calculations in assessing the severity of aortic stenosis (AS) in this patient population. Peak instantaneous pressure gradient showed a general correlation to but was overestimated by Doppler (r = 0.78, Doppler = 0.70 catheter + 19.9) and did not predict aortic valve area. Mean pressure gradient by Doppler correlated more closely with catheter mean gradient (r = 0.86, Doppler = 0.79 catheter + 6.1) but was a poor predictor of the severity of AS. In contrast, the continuity equation accurately predicted the aortic valve area by catheterization (r = 0.92, Doppler = 0.89 catheter -0.08). Thus, the continuity equation provides a reliable estimate of aortic valve area in patients with severe AR and should be used to evaluate the extent of AS in such patients when high systolic aortic velocities are present.

Full Text

Cited Authors

  • Grayburn, PA; Smith, MD; Harrison, MR; Gurley, JC; DeMaria, AN

Published Date

  • February 1, 1988

Published In

Volume / Issue

  • 61 / 4

Start / End Page

  • 376 - 381

PubMed ID

  • 2963521

Pubmed Central ID

  • 2963521

Electronic International Standard Serial Number (EISSN)

  • 1879-1913

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/0002-9149(88)90948-4


  • eng