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

Publication ,  Journal Article
Barker, PCA; Ensing, G; Ludomirsky, A; Bradley, DJ; Lloyd, TR; Rocchini, AP
Published in: J Am Soc Echocardiogr
December 2002

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.

Duke Scholars

Published In

J Am Soc Echocardiogr

DOI

ISSN

0894-7317

Publication Date

December 2002

Volume

15

Issue

12

Start / End Page

1496 / 1502

Location

United States

Related Subject Headings

  • Systole
  • Predictive Value of Tests
  • Infant, Newborn
  • Infant
  • Humans
  • Echocardiography, Doppler
  • Child, Preschool
  • Child
  • Cardiovascular System & Hematology
  • Cardiac Catheterization
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Barker, P. C. A., Ensing, G., Ludomirsky, A., Bradley, D. J., Lloyd, T. R., & Rocchini, A. P. (2002). Comparison of simultaneous invasive and noninvasive measurements of pressure gradients in congenital aortic valve stenosis. J Am Soc Echocardiogr, 15(12), 1496–1502. https://doi.org/10.1067/mje.2002.126415
Barker, Piers C. A., Gregory Ensing, Achiau Ludomirsky, David J. Bradley, Thomas R. Lloyd, and Albert P. Rocchini. “Comparison of simultaneous invasive and noninvasive measurements of pressure gradients in congenital aortic valve stenosis.J Am Soc Echocardiogr 15, no. 12 (December 2002): 1496–1502. https://doi.org/10.1067/mje.2002.126415.
Barker PCA, Ensing G, Ludomirsky A, Bradley DJ, Lloyd TR, Rocchini AP. Comparison of simultaneous invasive and noninvasive measurements of pressure gradients in congenital aortic valve stenosis. J Am Soc Echocardiogr. 2002 Dec;15(12):1496–502.
Barker, Piers C. A., et al. “Comparison of simultaneous invasive and noninvasive measurements of pressure gradients in congenital aortic valve stenosis.J Am Soc Echocardiogr, vol. 15, no. 12, Dec. 2002, pp. 1496–502. Pubmed, doi:10.1067/mje.2002.126415.
Barker PCA, Ensing G, Ludomirsky A, Bradley DJ, Lloyd TR, Rocchini AP. Comparison of simultaneous invasive and noninvasive measurements of pressure gradients in congenital aortic valve stenosis. J Am Soc Echocardiogr. 2002 Dec;15(12):1496–1502.
Journal cover image

Published In

J Am Soc Echocardiogr

DOI

ISSN

0894-7317

Publication Date

December 2002

Volume

15

Issue

12

Start / End Page

1496 / 1502

Location

United States

Related Subject Headings

  • Systole
  • Predictive Value of Tests
  • Infant, Newborn
  • Infant
  • Humans
  • Echocardiography, Doppler
  • Child, Preschool
  • Child
  • Cardiovascular System & Hematology
  • Cardiac Catheterization