Pressure recovery in aortic valve stenosis.
BACKGROUND
Pressure recovery is the variable increase in lateral pressure downstream from a stenotic orifice. The magnitude and clinical significance of pressure recovery in aortic valve stenosis are poorly defined.


RESULTS
We obtained high-fidelity pressure and velocity recordings in 11 patients with isolated significant aortic valve stenosis at the time of diagnostic cardiac catheterization. Systematic catheter pullback from the left ventricular cavity revealed a consistent although variable subvalvular gradient. Further pullback across and distal to the region of the stenosed aortic valve revealed a consistent and progressive increase in the ascending aortic pressure. This increase in lateral pressure occurred pari passu with a diminution in amplitude of the velocity pulse. The extent of pressure recovery was directly related to systemic blood flow and transvalvular flow but inversely related to the Gorlin-derived aortic valve area.


CONCLUSIONS
These findings have potentially important implications for the hemodynamic evaluation of mild to moderately severe aortic valve stenosis. The extent of pressure recovery may be of additional utility in the assessment of aortic valve stenosis under varying physiological states.
Laskey
W K
WK
Cardiac Catheterization Laboratory, Hospital of the University of Pennsylvania, Philadelphia 19104.
Kussmaul
W G
WG
D001011:Aorta / Q000502:physiology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D006328:Cardiac Catheterization; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male