DIAGNOSIS AND QUANTIFICATION OF AORTIC REGURGITATION BY DOPPLER ECHOCARDIOGRAPHY IN PATIENTS WITH AORTIC-STENOSIS AND MITRAL-VALVE DISEASE

  • 1 September 1986
    • journal article
    • research article
    • Vol. 75  (9) , 522-527
Abstract
To test the capacity of pulsed Doppler echocardiography in the detection and quantification of aortic regurgitation, 64 consecutive patients with aortic acid mitral valve disease were examined clinically and by echocardiography before cardiac catheterization. The severity of aortic regurgitation was determined angiographically (I-IV) and compared with the extent of the regurgitant jet in the left ventricle measured by pulsed Doppler echocardiography. In 15 of 64 patients neither angiography nor pulsed Doppler echocardiography showed aortic regurgitation (specificity 100%). Apart from 3 patients with poor echo quality pulsed Doppler echocardiography correctly detected aortic regurgitation in 46 of 49 patients (sensitivity 94%). Clinical examination (63%) and M-mode echocardiography (63%) were significantly less sensitive than Doppler echocardiography (p < 0.001). The pulsed Doppler echocardiographic degree of aortic regurgitation correlated strongly with angiography (corrected contingency coefficient 0.91). In patients with severe aortic stenosis (systolic gradient >50 mm Hg) aortic regurgitation 1.degree. was slightly overestimated by pulsed Doppler echocardiography (p < 0.003). Differentiation of aortic regurgitation III and IV was not possible. Mitral valve disease did not affect quantification of aortic regurgitation (n=23). Conclusions: Pulsed Doppler echocardiography is superior to auscultation and M-mode echocardiography in the diagnosis of aortic insufficiency and can reliably discriminate three degrees of aortic regurgitation (I-III). Aortic regurgitation 1.degree. is slightly overestimated in patients with severe aortic stenosis. Additional mitral valve disease does not affect quantification of aortic regurgitation by pulsed Doppler echocardiography.