Assessment of Doppler color flow mapping in quantification of aortic regurgitation--correlations and influencing factors.

Real-time two-dimensional Doppler echocardiography (Doppler color flow mapping) offers useful information on valvular regurgitation. In order to quantify aortic regurgitation by Doppler color flow mapping, this study determined the relationships between regurgitant jet dimensions and angiographic grades in 100 patients, and between regurgitant jet dimensions and regurgitant fractions or regurgitant volumes in 47. Doppler data were obtained using 4 different echo windows, parasternal long and short axes, and apical two- and four-chamber views. Maximum jet area, length and diameter taken from all available views were examined in relation to angiographic grades, regurgitant fractions and regurgitant volumes. Moreover, we analyzed the technical, biological and hemodynamic factors influencing these relationships. Significant correlations were found between all maximum jet dimensions and angiographic grade (diameter, r = 0.641; length, r = 0.549; area, r = 0.611; p less than 0.01). Means and standard deviations for maximum jet dimensions according to angiographic grading revealed significant differences between all grades except in jet length between grades 3 and 4. However, these relations tended to be influenced by various factors: equipment, echo window, shape of jet, coexistence with mitral stenosis or aortic stenosis, left ventricular size, left ventricular stroke volume, and diastolic blood pressure. On the other hand, with regurgitant fractions and regurgitant volumes, maximum jet dimensions correlated well (diameter, r = 0.614 and 0.567; length, r = 0.769 and 0.767; area, r = 0.791 and 0.773; p less than 0.01) when data associated with atrial fibrillation were excluded. Thus significant correlations between regurgitant jet dimensions in Doppler color flow mapping and angiographic grades can be obtained in all patients despite various factors influencing jet dimensions. Better correlations with regurgitant fractions or regurgitant volumes may be expected in patients with normal sinus rhythm.