1020-1 A New Method of Accurate Quantitation of Aortic Regurgitation Using Doppler Echocardiography

Estimation of aortic regurgitation (AR) by Doppler echocardiography (DE) may not correlate with cath, especially for inte mediate grades (II, III) of AR. The volume of the AR can be estimated as the product of the jet crosssectional area (JCSA) and the velocity time integral (VTI) of the AR jet. The purpose of this study was to determine the correlation of JCSA x VTI with AR grade at cath and to compare this with widely used method of jet-height to left ventricular outflow tract diameter ratio (JH/OTD). We analyzed 58 consecutive patients with AR who had both DE and contrast aortography. The maximal height of the AR jet on color flow Doppler was measured in the parasternal long axis view at the junction of the aortic annulus and Lvoutflow tract. JCSA was calculated as Π(JH/2)2. VTI was measured as the area under the continuous wave Doppler tracing of AR obtained from the apical view. Severity of AR on aortography was graded on a I–IV scaleResultsThe correlation (Spearman's rank, r) of JCSA x VTI with the AR grade at cath was superior to JH/OTD: 0.88 vs 0.77, P=0.02. The Table shows the relationship between the 4 grades of AR by cath vs JCSA x VTI (derived retrospectively). The accuracy of JCSA x VTI for grades II and III AR was 89% and 74% respectively, while the accuracy of JH/OTD for the same was 78% and 69% respectively (p=0.04 and p=0.05).ConclusionThe JCSA x VTI product is an easily obtained index of aortic regurgitant severity that closely correlates with AR grade obtained at cath. It is superior to JH/OTD for quantitation of AR, especially for intermediate grades of AR