Comparison of simultaneous invasive and noninvasive measurements of pressure gradients in congenital aortic valve stenosis.

Published

Journal Article

PURPOSE: Congenital aortic valve stenosis is a common problem in pediatric cardiology. The catheter peak to peak systolic gradient is the accepted standard used for prognosis and intervention, but noninvasive correlation in pediatric patients is frequently associated with underestimation or overestimation of this gradient. The purpose of this study was to compare different noninvasive measurements with simultaneous catheter gradients to identify which best predicts the catheter peak to peak gradient. METHODS: Twenty-five simultaneous Doppler and catheter measurements of aortic stenosis gradient were performed in 14 children (all 14 before valvuloplasty and 11 after valvuloplasty). Noninvasive estimates of pressure gradient were compared with catheter measurements with linear regression and Bland-Altman analysis. RESULTS: The Doppler peak instantaneous pressure gradient overestimated the catheter peak to peak gradient but correlated well with the catheter peak instantaneous gradient. The Doppler mean systolic gradient correlated well with the catheter peak to peak gradient at low gradients and underestimated higher catheter gradients but agreed well at all levels with the catheter mean gradient. The modification of a catheter-derived correlation equation produced good correlation with the catheter peak to peak gradient (slope, 1.14; intercept, -1.8; R, 0.92), as did the use of estimated pressure recovery (slope, 1.04; intercept, 5.0; R, 0.94), calculated from a defined fluid mechanic equation. CONCLUSION: The catheter peak to peak gradient can be accurately estimated noninvasively using estimated pressure recovery or correlation equations incorporating Doppler measurements.

Full Text

Duke Authors

Cited Authors

  • Barker, PCA; Ensing, G; Ludomirsky, A; Bradley, DJ; Lloyd, TR; Rocchini, AP

Published Date

  • December 2002

Published In

Volume / Issue

  • 15 / 12

Start / End Page

  • 1496 - 1502

PubMed ID

  • 12464918

Pubmed Central ID

  • 12464918

Electronic International Standard Serial Number (EISSN)

  • 1097-6795

International Standard Serial Number (ISSN)

  • 0894-7317

Digital Object Identifier (DOI)

  • 10.1067/mje.2002.126415

Language

  • eng