Two-Dimensional and Doppler Echocardiography Reliably Predict Severe Pulmonary Regurgitation as Quantified by Cardiac Magnetic Resonance

Renella, Pierangelo; Aboulhosn, Jamil; Lohan, Derek G.; Jonnala, Praveen; Finn, J. Paul; Satou, Gary M.; Williams, Ryan J.; Child, John S.

doi:10.1016/j.echo.2010.05.019

« Previous Next »Journal of the American Society of Echocardiography
Volume 23, Issue 8 , Pages 880-886, August 2010

Two-Dimensional and Doppler Echocardiography Reliably Predict Severe Pulmonary Regurgitation as Quantified by Cardiac Magnetic Resonance

Pierangelo Renella, MD
- Division of Pediatric Cardiology, Mattel Children's Hospital at the University of California, Los Angeles (UCLA), Los Angeles, California
Jamil Aboulhosn, MD
- Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, California
- Reprint requests: Jamil Aboulhosn, MD, Division of Cardiology, 650 Charles Young Drive, A2-237, Los Angeles, CA 90095.
Derek G. Lohan, MD
- Department of Radiology, UCLA Medical Center, Los Angeles, California
Praveen Jonnala, MD
- Department of Radiology, UCLA Medical Center, Los Angeles, California
J. Paul Finn, MD
- Department of Radiology, UCLA Medical Center, Los Angeles, California
Gary M. Satou, MD
- Division of Pediatric Cardiology, Mattel Children's Hospital at the University of California, Los Angeles (UCLA), Los Angeles, California
Ryan J. Williams
- Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, California
John S. Child, MD
- Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, California

published online 02 July 2010.

Background

The grading of pulmonary regurgitation (PR) severity by two-dimensional (2D) and Doppler echocardiography is not standardized. Cardiovascular magnetic resonance imaging is the clinical gold standard for PR quantification. The purpose of this study was to determine the best 2D and Doppler echocardiographic predictors of severe PR.

Methods

Thirty-six patients with tetralogy of Fallot or pulmonary valve stenosis with prior pulmonary valvuloplasty or transannular or subannular patch repair underwent 2D and Doppler echocardiography and cardiovascular magnetic resonance. Two-dimensional and Doppler echocardiographic measurements used to predict severe PR included diastolic flow reversal in the main or branch pulmonary arteries, PR jet width ≥ 50% of the pulmonary annulus, PR pressure half-time < 100 ms, and PR index < 0.77.

Results

With the exception of PR index, all indices were significant independent predictors of severe PR. The best univariate predictor of severe PR was branch pulmonary artery diastolic flow reversal.