Document Detail


Echocardiographic evaluation of pressure gradient across the stent in patients treated for coarctation of the aorta.
MedLine Citation:
PMID:  19664030     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Stent placement has become a widely used method of treatment for coarctation of the aorta (COA). Our goal was to find echocardiographic indices that would correlate best with directly measured gradients across the coarctation stent.
MATERIAL AND METHODS: Pediatric patients with COA who underwent intra-aortic stent placement were evaluated. Patients with more than mild aortic insufficiency were excluded. Aortic pressures above and below the coarctation site were directly measured in the catheterization laboratory. Echocardiography was performed the next morning. Continuous and Pulse Doppler systolic velocity profiles proximal and distal to the stent were recorded. Statistical analysis included Pearson's correlation coefficients and linear regression between the directly measured pressure gradient and strongest correlated factor.
RESULT: Thirty-four patients (F : M = 15 : 19) were included in the study. The directly measured gradients (DPG) had only weak positive correlations with Doppler peak velocities (r = 0.38, P= .027) or pressure gradients (r = 0.37, P= .03) across the stent. However, there was a strong positive correlation of the directly measured gradients with the continuous wave peak systolic velocity half-time indexed to heart rate (T) (r = 0.62, P= .03), and with the squared early diastolic velocity (V(d) (2)) (r = 0.073, P < .0001). When these two parameters were combined, a linear regression equation DPG = 0.06T + 1.58 V(d) (2)- 8.05 showed very strong relations (r = 0.81, P < .0001). A simplified equation DPG = 1.98V(d) (2)+ 0.77 also accurately described the relations between the directly measured gradients and squared Doppler-measured early diastolic velocity (r = 0.71, P= .0002).
CONCLUSIONS: A simple echocardiographic index DPG = 1.98V(d) (2)+ 0.77, where DPG is the pressure gradient across the stent, and V(d) is the early Doppler diastolic velocity, accurately describes relations between the gradient across the stent and echocardiographic data and should be used for evaluation of patients with stent-corrected COA.
Authors:
Liwen Tang; Thomas J Forbes; Wei Du; Mark V Zilberman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  4     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-10-29     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  269-72     Citation Subset:  IM    
Affiliation:
Cardiology Division, Department of Pediatrics, Wayne State University School of Medicine, Detroit, Mich 48201, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Angioplasty*
Aorta, Thoracic / physiology,  ultrasonography*
Aortic Coarctation / therapy*,  ultrasonography*
Child
Child, Preschool
Diastole
Echocardiography*
Female
Heart Rate
Humans
Male
Pressure
Stents*
Systole
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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