[The effect of concomitant aortic valve insufficiency on the values of Doppler sonographic gradient determination in patients with aortic stenosis].
We examined the influence of concomitant significant aortic incompetence (AI) on Doppler-gradient measurements in valvular aortic stenosis (AS) by comparing catheter and Doppler gradients of 51 patients with isolated AS and of 24 patients with additional AI. In patients with additional AI there was a significantly greater overestimation of the peak-to-peak gradient by the maximal instantaneous Doppler gradient (AS + AI: overestimation 31.0 +/- 17.6 mm Hg, AS: overestimation 10.5 +/- 20.2 mm Hg; p less than 0.01) and also by the maximal instantaneous catheter gradient (AS + AI: overestimation 32.8 +/- 11.8 mm Hg, AS: overestimation 20.4 +/- 14.0 mm Hg; p less than 0.01). Comparison of the respective catheter-derived and Doppler-sonographically measured instantaneous and mean gradients showed no differences between the two patient subgroups. Higher instantaneous gradients in patients with additional AI are mainly explained by the lower end-diastolic aortic pressure. However, Doppler-sonographic overestimation of the severity of stenosis in patients with combined AS + AI, due to the sole measurement of the instantaneous gradient in clinical practice, should be of limited importance because in these patients significant AI already sufficiently indicates aortic valve replacement.
Siostrzonek
P
P
I. Medizinische Universitätsklinik Wien.
Kronik
G
G
Jung
M
M
Gössinger
H
H
Schmoliner
R
R
Zangeneh
M
M
Salzer
U
U
Klicpera
M
M
Mösslacher
H
H
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
Einfluss der begleitenden Aorteninsuffizienz auf das Ergebnis der dopplersonographischen Gradientenbestimmung bei Patienten mit Aortenstenose.