Influence of transmitral filling dynamics on continuous-wave Doppler assessment of aortic regurgitation by half-time methods

The influence of transmitral filling dynamics on the evaluation of aortic regurgitation (AR) by continuous-wave Doppler pressure half-time was assessed in 30 consecutive patients in sinus rhythm with chronic moderate to severe AR. Pulsed-wave Doppler-derived regurgitant fraction (obtained from aortic and pulmonary stroke volumes) and color flow mapping relative regurgitant area (obtained from the parasternal short-axis view) were chosen as reference standards for the severity of AR. An excellent correlation was found between these 2 parameters (r = 0.98), while correlations were poor between pressure half-time and either regurgitant fraction (r = -0.74) or relative regurgitant jet area (r = -0.69). The ratio of early (E) to late (A) transmitral peak velocities was used to divide the study population into 2 groups: group A (n = 16) with E/A less than 1 and group B (n = 14) with E/A greater than 1. In patients with a similar degree of AR (estimated from Doppler regurgitant fraction or relative regurgitant jet area), the pressure half-time was found to be significantly shorter. Thus, the severity of AR in group A patients was overestimated (p less than 0.01). Compared to group B, group A patients were significantly shorter. Thus, the severity of AR in group A patients was overestimated (p less than 0.01). Compared to group B, group A patients were significantly older (p less than 0.02) and had a larger left ventricular mass (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)