Doppler assessment of interventricular pressure gradient across isolated ventricular septal defect.
Continuous wave Doppler ultrasound was used to estimate the pressure gradient between the right and left ventricle for assessment of pulmonary arterial systolic pressure in 30 patients with isolated ventricular septal defect and for subsequent comparison with similar data obtained on cardiac catheterization. The age of the patients ranged from 8 months to 45 years (6.8 +/- 8.6 years). No patient had right or left ventricular outflow tract obstruction. Doppler measurements were done within 24 h of cardiac catheterization. Pressure gradient across ventricular septal defect on cardiac catheterization ranged from 7 to 95 mmHg (48 +/- 24 mmHg) and that on Doppler assessment ranged from 8 to 78 mmHg (42 +/- 20 mmHg). Doppler measurements of interventricular pressure gradient correlated well with those obtained on cardiac catheterization (r = 0.90, p less than 0.001). Correlation was better in patients with pressure gradient across ventricular septal defect less than 75 mmHg (r = 0.96). Correlation was poor in three of five patients with very small ventricular septal defects (interventricular pressure gradient greater than 75 mmHg) because the jet used was not ideal. Thus continuous wave Doppler ultrasound is an accurate noninvasive means of measuring pressure gradient across ventricular septal defect, which is a useful parameter for assessment of pulmonary artery systolic pressure in patients with isolated ventricular septal defect without right and left ventricular outflow tract obstruction.
Garg
A
A
Department of Cardiology, All India Institute of Medical Sciences, New Delhi.
Shrivastava
S
S
Radhakrishnan
S
S
Dev
V
V
Saxena
A
A
D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology*