A new echocardiographic method for the assessment of the severity of aortic regurgitation: Color M-mode flow propagation velocity

Abstract

Purpose: Echocardiographic Doppler methods widely used in assessment of the severity of aortic regurgitation (AR) are considered sensitive and reliable. However, they all have limitations for quantitation of AR. The color M-mode Doppler flow propagation velocity (FPV) method has been shown to provide useful insights in the evaluation of left ventricular diastolic function and appears to be minimally affected with preload changes. Clinical data regarding the value of FPV in the determination of the significance of valvular insuffiencies are lacking. The purpose of this study was to evaluate the use of FPV in measurement of the severity of AR and to compare its reliability with angiography and other echocardiographic methods. Methods: Twenty-nine patients (13 male, 16 female) who had cardiac catheterization for various reasons before echocardiographic evaluation were included. The mean age was 53.6 ± 13.4 years. At the time of cardiac catheterization, the degree of AR was assessed as mild in 10 patients, as moderate in 12, and as severe in 7. In all patients, FPV measurements of AR were obtained with color M-mode Doppler in the apical 5-chamber view. Regurgitation jet height and its ratio to left ventricular outflow obtained in the parasternal long axis with color flow Doppler, pressure half-time, and slope of AR obtained with continuous wave Doppler in apical 5-chamber view were other echocardiographic methods chosen for comparison. Results: The mean values of FPV were 93.1 ± 18.4 cm/s, 49.8 ± 8.0 cm/s, and 31.7 ± 4.9 cm/s in severe, moderate, and mild AR groups, respectively (P <.001). Significant correlation was observed between angiographic grades, FPV, pressure half-time, slope, and jet height and ratio to left ventricular outflow (P <.0001, r = 0.93; P <.0001, r = −0.81; P <.0001, r = 0.76; P <.0001, r = 0.92, respectively). Conclusion: FPV is a simple, practical, and reliable method for the quantification of AR. (J Am Soc Echocardiogr 2002;15:1453-60.)