The relation between transaortic pressure difference and flow during dobutamine stress echocardiography in patients with aortic stenosis
S Takeda, H Rimington, J Chambers
Adult
Echocardiography, Guy's and St Thomas' Hospitals, Cardiothoracic
Centre, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK
Correspondence to: Dr Chambers.
Accepted for publication 26 January 1999
OBJECTIVE
To
investigate the relation between transaortic pressure difference and
flow in patients with aortic stenosis.
METHODS50
asymptomatic patients with all grades of aortic stenosis were studied
using dobutamine stress echocardiography. Individual plots of mean
pressure drop against flow were drawn. Comparisons were made between
grades of aortic stenosis as defined by the continuity equation.
RESULTSA significant
linear relation between pressure difference and flow was found in 34 patients (68%). There was a significant curvilinear relation in four
(8%), while no significant regression line could be fitted in 12 (24%). In the 34 patients with linear fits, the slopes (mean (SD))
were 0.08 (0.07) in mild, 0.10 (0.04) in moderate, and 0.22 (0.16) in
severe aortic stenosis (p = 0.0055).
CONCLUSIONSTransaortic
pressure difference can be related directly to flow in many patients
with all grades of aortic stenosis. However, there are individual
differences in slope and intercept suggesting that resistance
calculated at rest may not always be representative. Raw pressure
drop/flow plots may be an alternative method of describing valve function.
Keywords: aortic stenosis; continuity equation; resistance; Doppler echocardiography
© 1999 by Heart
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