Document Detail


Quantitative assessment of pulmonary insufficiency by Doppler echocardiography in patients with adult congenital heart disease.
MedLine Citation:
PMID:  17869058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We determined the utility of continuous wave (CW) Doppler for quantification of pulmonary insufficiency (PI) confirmed by pulmonary angiography in patients with postoperative adult congenital heart disease. A total of 41 patients with PI were divided into two groups on the basis of PI severity by pulmonary angiography: group A (n = 27) with severe PI and group B (n = 14) with mild or moderate PI. Nine patients in group A had pulmonic valve replacement and reverted to mild PI after surgery. Their pre- and postoperative data were compared. All underwent a two-dimensional/Doppler study with interrogation of the PI jet for jet width by color Doppler and peak flow velocity, deceleration time (DT), pressure half-time (PHT), diastolic period (DP), and PI flow time (FT) by CW Doppler. The no-flow time (NFT), NFT/FT ratio, and NFT/DP fraction were calculated. Group A had a larger right ventricle (4.1 +/- 0.9 vs. 3.5 +/- 0.6 cm, P = .033), higher PI peak velocity (2.1 +/- 0.5 vs. 1.7 +/- 0.5 m/s, P = .04), shorter DT (261 +/- 61 vs. 317 +/- 83 ms, P = .018) and PHT (76 +/- 29 vs. 132 +/- 53, P < .0001), longer NFT (146 +/- 66 vs. 40 +/- 42 ms, P < .0001), and higher ratios of NFT/FT (46% +/- 27% vs. 13% +/- 14%, P < .0001) and NFT/DP (29% +/- 13% vs. 10% +/- 9%, P < .0001). The PHT and DT lengthened, and the NFT shortened in patients who underwent pulmonic valve replacement (all P < .05). By binary logistic regression, NFT and PHT were the best predictors for severe PI. An NFT of 80 ms had 84% sensitivity and 93% specificity, and a PHT of 100 ms had 93% sensitivity and 93% specificity for identifying angiographically severe PI. CW Doppler accurately distinguishes severe from lesser degrees of PI in patients with postoperative adult congenital heart disease.
Authors:
Hua Yang; Min Pu; Charles E Chambers; Howard S Weber; John L Myers; William R Davidson
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-09-14
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  21     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-11     Completed Date:  2008-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  157-64     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography
Cardiac Surgical Procedures / methods
Cohort Studies
Echocardiography, Doppler, Color / methods*
Female
Follow-Up Studies
Heart Catheterization
Heart Defects, Congenital / complications,  surgery,  ultrasonography*
Heart Valve Prosthesis Implantation / methods
Humans
Logistic Models
Male
Postoperative Care / methods
Predictive Value of Tests
Pulmonary Valve Insufficiency / complications,  surgery*,  ultrasonography*
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Vascular Resistance

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


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