Two-dimensional and Doppler echocardiography reliably predict severe pulmonary regurgitation as quantified by cardiac magnetic resonance.
BACKGROUND
The grading of pulmonary regurgitation (PR) severity by two-dimensional (2D) and Doppler echocardiography is not standardized. Cardiovascular magnetic resonance imaging is the clinical gold standard for PR quantification. The purpose of this study was to determine the best 2D and Doppler echocardiographic predictors of severe PR.


METHODS
Thirty-six patients with tetralogy of Fallot or pulmonary valve stenosis with prior pulmonary valvuloplasty or transannular or subannular patch repair underwent 2D and Doppler echocardiography and cardiovascular magnetic resonance. Two-dimensional and Doppler echocardiographic measurements used to predict severe PR included diastolic flow reversal in the main or branch pulmonary arteries, PR jet width > or = 50% of the pulmonary annulus, PR pressure half-time < 100 ms, and PR index < 0.77.


RESULTS
With the exception of PR index, all indices were significant independent predictors of severe PR. The best univariate predictor of severe PR was branch pulmonary artery diastolic flow reversal.


CONCLUSIONS
Two-dimensional and Doppler echocardiography reliably identified severe PR in this cohort.
Renella
Pierangelo
P
Division of Pediatric Cardiology, Mattel Children's Hospital at the University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
Aboulhosn
Jamil
J
Lohan
Derek G
DG
Jonnala
Praveen
P
Finn
J Paul
JP
Satou
Gary M
GM
Williams
Ryan J
RJ
Child
John S
JS
D000328:Adult; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity