Importance of Pressure Recovery for the Assessment of Aortic Stenosis by Doppler Ultrasound

Abstract
Background Pressure recovery has been shown to occur distal to aortic stenoses in experimental and clinical studies. However, its clinical relevance in this setting has not yet been evaluated. Methods and Results To address the hypothesis that pressure recovery can cause significant differences between Doppler and catheter gradients in aortic stenosis and to examine the effects of aortic size, aortic valve area, and direction of the stenotic jet on these differences, stenoses with valve areas from 0.5 to 1.25 cm2 and aortic diameters from 1.8 to 5.0 cm were studied in a pulsatile flow model. Jets entered the aorta centrally or eccentrically with angles of 15°, 30°, or 45°. Overall, good correlation was found between Doppler and catheter gradients. However, when the various combinations of orifices and aortas were analyzed separately, slopes varied from 1.0 to 1.86, and the Doppler-catheter gradient differences ranged from −2 (small valve area with a large aorta) to 66 mm Hg (80% overestimation by Doppler ...

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