A new approach to noninvasive evaluation of aortic regurgitant fraction by two-dimensional Doppler echocardiography

A. Kitabatake, Hiroshi Itoh, M. Inoue, J. Tanouchi, K. Ishihara, T. Morita, K. Fujii, Y. Yoshida, T. Masuyama, H. Yoshima

Research output: Contribution to journalArticle

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Abstract

The aortic regurgitant fraction was estimated noninvasively in 20 patients with aortic regurgitation from systolic aortic and pulmonary volume flow determined by duplex Doppler echocardiography. By assuming that an excess of the aortic volume flow (AF) compared with the pulmonary volume flow (PF) is due to aortic regurgitant flow, the aortic regurgitant fraction (RF) was calculated as follows: RF(%) = (AF - PF)/AF x 100. The aortic and pulmonary volume flows were determined as products of systolic integrals of ejection flow velocities and cross-sectional areas of the left and right ventricular outflow tracts, respectively. The Doppler estimate of the regurgitant fraction was compared by semiquantitative grading (1 + to 4 +) by cineaortography and with the measurement of regurgitant fraction by catheter technique. The mean Doppler-determined aortic regurgitant fraction was 2.4% for normal subjects, 28.0% for the patients with 1 + , 32.6% for the patients with 2+, 53.5% for the patients with 3+, and 62.4% for the patient with 4+. A fair correlation was found between Doppler estimates of regurgitant fraction and semiquantitative cineaortographic grades (r = .80, p <.01). In the patients without associated mitral regurgitation, a close correlation was observed between Doppler and catheter estimates of regurgitant fraction (r = .96, p <.01; y = 1.0x = 0.08). In the patients with associated mild mitral regurgitation, however, Doppler estimates of regurgitant fraction substantially underestimated those determined by the conventional catheter technique, which cannot separately quantitate the aortic regurgitant fraction in the presence of mitral regurgitation. These observations indicate that the proposed Doppler technique provides a useful method to evaluate the aortic regurgitant fraction specifically regardless of the presence of associated mitral lesions.

Original languageEnglish
Pages (from-to)523-529
Number of pages7
JournalCirculation
Volume72
Issue number3
Publication statusPublished - 1985
Externally publishedYes

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Doppler Echocardiography
Mitral Valve Insufficiency
Lung
Catheters
Aortic Valve Insufficiency

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Kitabatake, A., Itoh, H., Inoue, M., Tanouchi, J., Ishihara, K., Morita, T., ... Yoshima, H. (1985). A new approach to noninvasive evaluation of aortic regurgitant fraction by two-dimensional Doppler echocardiography. Circulation, 72(3), 523-529.

A new approach to noninvasive evaluation of aortic regurgitant fraction by two-dimensional Doppler echocardiography. / Kitabatake, A.; Itoh, Hiroshi; Inoue, M.; Tanouchi, J.; Ishihara, K.; Morita, T.; Fujii, K.; Yoshida, Y.; Masuyama, T.; Yoshima, H.

In: Circulation, Vol. 72, No. 3, 1985, p. 523-529.

Research output: Contribution to journalArticle

Kitabatake, A, Itoh, H, Inoue, M, Tanouchi, J, Ishihara, K, Morita, T, Fujii, K, Yoshida, Y, Masuyama, T & Yoshima, H 1985, 'A new approach to noninvasive evaluation of aortic regurgitant fraction by two-dimensional Doppler echocardiography', Circulation, vol. 72, no. 3, pp. 523-529.
Kitabatake, A. ; Itoh, Hiroshi ; Inoue, M. ; Tanouchi, J. ; Ishihara, K. ; Morita, T. ; Fujii, K. ; Yoshida, Y. ; Masuyama, T. ; Yoshima, H. / A new approach to noninvasive evaluation of aortic regurgitant fraction by two-dimensional Doppler echocardiography. In: Circulation. 1985 ; Vol. 72, No. 3. pp. 523-529.
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AU - Kitabatake, A.

AU - Itoh, Hiroshi

AU - Inoue, M.

AU - Tanouchi, J.

AU - Ishihara, K.

AU - Morita, T.

AU - Fujii, K.

AU - Yoshida, Y.

AU - Masuyama, T.

AU - Yoshima, H.

PY - 1985

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N2 - The aortic regurgitant fraction was estimated noninvasively in 20 patients with aortic regurgitation from systolic aortic and pulmonary volume flow determined by duplex Doppler echocardiography. By assuming that an excess of the aortic volume flow (AF) compared with the pulmonary volume flow (PF) is due to aortic regurgitant flow, the aortic regurgitant fraction (RF) was calculated as follows: RF(%) = (AF - PF)/AF x 100. The aortic and pulmonary volume flows were determined as products of systolic integrals of ejection flow velocities and cross-sectional areas of the left and right ventricular outflow tracts, respectively. The Doppler estimate of the regurgitant fraction was compared by semiquantitative grading (1 + to 4 +) by cineaortography and with the measurement of regurgitant fraction by catheter technique. The mean Doppler-determined aortic regurgitant fraction was 2.4% for normal subjects, 28.0% for the patients with 1 + , 32.6% for the patients with 2+, 53.5% for the patients with 3+, and 62.4% for the patient with 4+. A fair correlation was found between Doppler estimates of regurgitant fraction and semiquantitative cineaortographic grades (r = .80, p <.01). In the patients without associated mitral regurgitation, a close correlation was observed between Doppler and catheter estimates of regurgitant fraction (r = .96, p <.01; y = 1.0x = 0.08). In the patients with associated mild mitral regurgitation, however, Doppler estimates of regurgitant fraction substantially underestimated those determined by the conventional catheter technique, which cannot separately quantitate the aortic regurgitant fraction in the presence of mitral regurgitation. These observations indicate that the proposed Doppler technique provides a useful method to evaluate the aortic regurgitant fraction specifically regardless of the presence of associated mitral lesions.

AB - The aortic regurgitant fraction was estimated noninvasively in 20 patients with aortic regurgitation from systolic aortic and pulmonary volume flow determined by duplex Doppler echocardiography. By assuming that an excess of the aortic volume flow (AF) compared with the pulmonary volume flow (PF) is due to aortic regurgitant flow, the aortic regurgitant fraction (RF) was calculated as follows: RF(%) = (AF - PF)/AF x 100. The aortic and pulmonary volume flows were determined as products of systolic integrals of ejection flow velocities and cross-sectional areas of the left and right ventricular outflow tracts, respectively. The Doppler estimate of the regurgitant fraction was compared by semiquantitative grading (1 + to 4 +) by cineaortography and with the measurement of regurgitant fraction by catheter technique. The mean Doppler-determined aortic regurgitant fraction was 2.4% for normal subjects, 28.0% for the patients with 1 + , 32.6% for the patients with 2+, 53.5% for the patients with 3+, and 62.4% for the patient with 4+. A fair correlation was found between Doppler estimates of regurgitant fraction and semiquantitative cineaortographic grades (r = .80, p <.01). In the patients without associated mitral regurgitation, a close correlation was observed between Doppler and catheter estimates of regurgitant fraction (r = .96, p <.01; y = 1.0x = 0.08). In the patients with associated mild mitral regurgitation, however, Doppler estimates of regurgitant fraction substantially underestimated those determined by the conventional catheter technique, which cannot separately quantitate the aortic regurgitant fraction in the presence of mitral regurgitation. These observations indicate that the proposed Doppler technique provides a useful method to evaluate the aortic regurgitant fraction specifically regardless of the presence of associated mitral lesions.

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