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The Estimation of Pressure Gradients of the various Cardiac Chambers Using Conbtinuos-Wave Doppler Echocardiography in Congenital Heart Disease.

Journal of the Korean Pediatric Society 1990;33(3):324-331.
Published online March 31, 1990.
The Estimation of Pressure Gradients of the various Cardiac Chambers Using Conbtinuos-Wave Doppler Echocardiography in Congenital Heart Disease.
Du Young Choi, Yeon Sim Kim, Hyung Suk Yoon
Department of Pediatrics, School of Medicine, Wonkwang University, I-Ri, Korea
선천성 심질환에서 연속파형 Doppler 심초음파를 이용한 심장 각 부의 압력차이 측정
최두영, 김연심, 윤향석
원광대학교 의과대학 소아과학교실
Received: 19 September 1989   • Accepted: 13 November 1989
Abstract
Continuous-Wave doppler echocardiography was used to estimate the Pressure gradient in 55 children with congenital heart disease. To test whether the Doppler method would be useful for evaluation and management of pediatric patients with ventricular septal defect (VSD)), pulmonic stenosis (PS), tricuspid regurgitation (TR), we recorded the maximal velocity (Vmax) of transseptal, pulmonary and regurgitant tricuspid jet flows and calculated the pressure gradients used by simplified Bernoulli equation (p=4V2). Doppler- predicted gradient was compared with the data of catheterization. The results were as follows; 1) The best correlation of gradients between doppler and catherization was shown in children with VSD (r=0.94, Cath(mmHg)=0.99, Doppler (mmHg)+1.36). 2) There was good correlations between the gradients of Doppler and catheterization in patients with PS (r=0.82), TR (r=0.86). 3) In isolated VSD, statistically inverse correlation betwen the ratio of pulmonary to systemic vascular resistance (Rp/Rs) and Vmax was shown (r=0.77). 4) Limitations shown in this syudy was found in subaortic VSD with prolapse of coronary cusps, markedly elevated right ventricular pressure (RVP) (>200 mmHg) and in mild TR (Vmax <2.0 m/ sec). We conclude that continuous-wave doppler technique can estimate RVP and degree of the pul- monary artery hypertension in patients with VSD or TR. Measuring the transpulmonary pressure gradients can be used for assessment of the degree of PS as well as the follow-up of pulmonary valvuloplasty noninvasively.
Key Words: Doppler echocardiography. pressure gradients. Ventricular septal defect, pulmonary stenosis, tricuspid regurgitation.


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