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Severity of Aortic Regurgitation Assessed by Digital Image Processing of Doppler Spectral Recordings
Author(s) -
TAK TAHIR,
MATHEWS SAJEN,
CHANDRARATNA P.A.N.
Publication year - 1996
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.1996.tb00894.x
Subject(s) - medicine , cardiology , concomitant , doppler effect , stenosis , nuclear medicine , physics , astronomy
Visual estimates of the intensity of the regurgitant signal (RS) obtained by continuous‐wave (CW) Doppler has been used as an indicator of the severity of aortic regurgitation (AR). This study was designed to test this concept quantitatively using digital image processing methods. Twenty‐one patients with AR were studied, 14 of whom had concomitant mitral valve disease. Patients with aortic stenosis were excluded. By angiography, 10 patients had mild (grade 1 or 2), 5 had moderate (grade 3), and 6 severe (grade 4) AR. We digitized three well‐defined AR envelopes and calculated the mean pixel intensity (MPI) of the RS and the systolic flow signal (SFS) using an offline computer analysis system developed in our laboratory. To negate the effects of different gain settings, the ratio of RS to SFS (RS/SFS ratio) was compared to angiographic grade of AR. Thus, each patient served as his own control. The mean RS/SFS ratio was 0.54 ± 0.42 SD (range 0.46‐0.59) for mild AR, 0.76 ± 0.71 SD (range 0.65‐0.82) for moderate AR, and 0.84 ± 0.52 (range 0.77‐0.92) for severe AR. This RS/SFS ratio correlated well with angiographic severity of AR (r = 0.9). A ratio of > 0.6 identified patients with mild AR and < 0.6 correlated with moderate‐to‐severe. AR. We conclude that the ratio of the regurgitant to systolic flow CW Doppler signal is an accurate noninvasive indicator of AR severity.