Assessment of supra-valvular abnormal signal with color doppler flow mapping in patients with aortic regurgitation

ABSTRACT

Three parameters, viz., a supra-aortic abnormal flow signal [proximal acceleration], the short axis area of the regurgitant jet relative to the short axis area of the left ventricular outflow tract at the level of the high left ventricular outflow tract and the thickness of the regurgitant jet at its origin relative to size of the left ventricular outflow tract, were studied in 30 patients with aortic regurgitation with the use of color Doppler flow mapping. The color Doppler echocardiographic studies and aortic angiograms of all patients were performed within 24-48 hours of each other. The sensitivity for the diagnosis of severe regurgitation from the existence of a proximal acceleration signal was 100% and the sensitivity for the diagnosis of severe regurgitation from all area of proximal acceleration of more than 45 mm2 was 88.8% These results suggest that evaluation of the area of the supra-aortic abnormal signal may be a useful auxiliary aid in estimating the severity of aortic regurgitation. The thickness of the regurgitant stream at its origin in the high left ventricular outflow tract relative to the size of the left ventricular outflow tract, measured in either one dimension [jet height from the parasternal long axis view] or two dimensions [jet short axis area in the high left ventricular outflow tract], can predict the severity of aortic regurgitation as determined by angiographic grading r= 0.90 [P 0.001] and r = 0.49 [P] respectively