@article{bb04b6a827e24354b71b0bd212e8ddac,
title = "Aortic flow velocity patterns in chronic aortic regurgitation: implications for Doppler echocardiography.",
abstract = "Aortic regurgitation is associated with retrograde diastolic flow in the aorta. Echocardiographic quantitative analysis of the magnitude of the flow reversal is believed to provide an estimate of severity of regurgitant disease despite variations in flow profiles. The purpose of this study was to evaluate the uniformity of flow patterns in the aorta of patients with aortic regurgitation and to investigate the relationship between these profiles and the echocardiographic estimates of flow reversal. Seventeen patients with chronic aortic regurgitation underwent cine-phase magnetic resonance imaging in an axial section through the ascending and descending aorta. The regurgitant fraction in the ascending aorta 4 cm above the aortic valve and the descending aorta were calculated from the velocity maps. These results were compared with data from nine individual sample volumes in the ascending and descending aorta. The magnetic resonance ascending aortic regurgitant fraction was compared with Doppler echocardiographic descending aortic flow velocity patterns. The descending aortic regurgitant fraction correlated only weakly with the ascending aortic regurgitant fraction (descending aortic regurgitant fraction = 0.62% ascending aortic regurgitant fraction + 0.04%; r = 0.75; p < 0.001). Regurgitant proportions in all sample volumes in the descending aorta, but not in the ascending aorta, were significantly related to the ascending aortic regurgitant fraction. The best descending aortic Doppler echocardiographic parameter for predicting ascending aortic regurgitant fraction was the end-diastolic velocity (end-diastolic velocity = 32.2 cm/sec. ascending aortic regurgitant fraction + 1.4 cm/sec; r = 0.94; p < 0.001). Pulsedwave Doppler sampling of descending aortic flow reflects severity of aortic regurgitant disease, in part the result of more uniform blood-velocity profiles in the descending aorta compared with the ascending aorta. The Doppler end-diastolic velocity in the descending aorta is a useful parameter of severity of aortic regurgitation.",
author = "Reimold, {S. C.} and Maier, {S. E.} and K. Aggarwal and Fleischmann, {K. E.} and D. Piwnica-Worms and R. Kikinis and Lee, {R. T.}",
note = "Funding Information: Sharon C. Reimold, MD, a Stephan E. Maier, MD, PhD, b Kavita Aggarwal, AB, Kirsten E. Fleischmann, MD, c David Piwnica-Worms, MD, PhD, a Ron Kikinis, MD, and Richard T. Lce, MD, Boston, Massachusetts Aortic regurgitation is associated with retrograde diastolic flow in the aorta. Echocardiographic quantitative analysis of the magnitude of the flow reversal is believed to provide an estimate of severity of regurgitant disease despite variations in flow profiles. The purpose of this study was to evaluate the uniformity of flow patterns in the aorta of patients with aortic regurgitation and to investigate the relationship between these profiles and the echocardiographic estimates of flow reversal. Seventeen patients with chronic aortic regurgitation underwent cine-phase magnetic resonance imaging in an axial section through the ascending and descending aorta. The regurgitant fraction in the ascending aorta 4 cm above the aortic valve and the descending aorta were calculated from the velocity maps. These results were compared with data from nine individual sample volumes in the ascending and descending aorta. The magnetic resonance ascending aortic regurgitant fraction was compared with Doppler echocardiographic descending aortic flow velocity pat- Oeverity ~2 of aortic regurgitant disease may be estimated clinically by determining the volume of regurgitation through the valve, the impact of regurgitation on left ventricular size and function, and the extent of diastolic flow reversal in the aorta. The impact of aortic regurgitation on left ventricular From the CardiovascularD ivision, Department of Medicine, and the Department of Radiology, Brigham and Women's Hospital. Supported in part by a grant from Boots Pharmaceuticals, Shreveport, Louisiana. ~Recipient of a Clinical Investigator Development Award from the National Heart, Lung, and Blood Institute (HL-02758). bSupported by the Swiss National Science Foundation. 'Recipient of a 1993-94 American College of Cardiology/Merck Fellowship. aRecipient of an Established Investigator Award from the American Heart Association. Reprint requests: Sharon C. Reimold, MD, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115. Copyright {\textcopyright} 1996 by the American Society of Echocardiography. 0894-7317/96 $5.00 + 0 27/1/72758 terns. The descending aortic regurgitant fraction correlated only weakly with the ascending aortic regurgitant fraction (descending aortic regurgitant fraction = 0.62%. ascending aortic regurgitant fraction + 0.04%; r = 0.75; p < 0.001). Regurgitant proportions in all sample volumes in the descending aorta, but not in the ascending aorta, were significantly related to the ascending aortic regurgitant fraction. The best descending aortic Doppler echocardiographic parameter for predicting ascending aortic regurgitant fraction was the end-diastolic velocity (end-diastolic velocity = 32.2 cm/sec, ascending aortic regurgitant fraction + 1.4 cm/sec; r = 0.94; p < 0.001). Pulsed-wave Doppler sampling of descending aortic flow reflects severity of aortic regurgitant disease, in part the result of more uniform blood-velocity profiles in the descending aorta compared with the ascending aorta. The Doppler end-diastolic velocity in the descending aorta is a useful parameter of severity of aortic regurgitation. (J Am Soc Ech0cardiogr 1996;9:675-83.) structure may be assessed by measuring the left ventricular end-diastolic and end-systolic dimensions, volumes, wall thickness, and ejection fraction. ~ Aortic regurgitation is also associated with altered aortic blood flow patterns. Patients with more severe aortic regurgitation may have a greater degree of diastolic flow reversal in the aorta, reflecting a larger amount of retrograde flow through the incompetent aortic valve. 2{"}3 The ratio of diastolic/systolic flow through the aortic valve and aorta is the regurgitant fraction, a parameter that may be affected by heart rate, pre-load, contractility, and aftcrload. Echocardiographic parameters in the descending aorta, including the persistence of retrograde flow throughout diastole, elevation of end-diastolic retrograde velocities, and high diastolic/systolic flow ratios, have been suggested as indicators of increasing severity of aortic regurgitation. 3{"}4 Doppler flow patterns within the ascending aorta also have been examined as measures of regurgitant severity, s'6 There has been concern about use of quantitation of ascending aortic flow patterns as an",
year = "1996",
doi = "10.1016/S0894-7317(96)90064-4",
language = "English (US)",
volume = "9",
pages = "675--683",
journal = "Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "5",
}