All issues > Volume 33(3); 1990

Original Article

J Korean Pediatr Soc. 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 Choi¹, Yeon Sim Kim¹, Hyung Suk Yoon¹

¹Department of Pediatrics, School of Medicine, Wonkwang University, I-Ri, Korea

Received: September 19, 1989;  Accepted: November 13, 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.

Keywords :Doppler echocardiography. pressure gradients. Ventricular septal defect, pulmonary stenosis, tricuspid regurgitation.