Flow-Dependent Changes in Doppler-Derived Aortic Valve Effective Orifice Area Are Real and Not Due to Artifact
| Autor: | Jean G. Dumesnil, Lyes Kadem, Louis-Gilles Durand, Régis Rieu, Philippe Pibarot |
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| Přispěvatelé: | Institut de Recherche sur les Phénomènes Hors Equilibre (IRPHE), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM), Biomedical Engineering Laboratory, Université de Montréal (UdeM)-Institut de recherches cliniques de Montréal, Institut de cardiologie de Québec, Université Laval [Québec] (ULaval)-Centre Hospitalier de Laval (CH Laval), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2006 |
| Předmět: |
Aortic valve
Cardiac Catheterization medicine.medical_specialty Flow (psychology) Hemodynamics 030204 cardiovascular system & hematology [SPI.MECA.MEFL]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Fluids mechanics [physics.class-ph] 03 medical and health sciences 0302 clinical medicine Internal medicine Laser-Doppler Flowmetry medicine Humans [PHYS.MECA.MEFL]Physics [physics]/Mechanics [physics]/Fluid mechanics [physics.class-ph] 030212 general & internal medicine Bioprosthesis business.industry Models Cardiovascular Aortic Valve Stenosis Stroke volume Laser Doppler velocimetry Echocardiography Doppler Surgery Volumetric flow rate Models Structural medicine.anatomical_structure Particle image velocimetry Aortic Valve Heart Valve Prosthesis Cardiology sense organs Artifacts Cardiology and Cardiovascular Medicine business Blood Flow Velocity Body orifice |
| Zdroj: | Journal of the American College of Cardiology Journal of the American College of Cardiology, Elsevier, 2006, 47 (1), pp.131-137. ⟨10.1016/j.jacc.2005.05.100⟩ Journal of the American College of Cardiology, 2006, 47 (1), pp.131-137. ⟨10.1016/j.jacc.2005.05.100⟩ |
| ISSN: | 0735-1097 1558-3597 |
| DOI: | 10.1016/j.jacc.2005.05.100 |
| Popis: | International audience; OBJECTIVES: We sought to determine whether the flow-dependent changes in Doppler-derived valve effective orifice area (EOA) are real or due to artifact. BACKGROUND: It has frequently been reported that the EOA may vary with transvalvular flow in patients with aortic stenosis. However, the explanation of the flow dependence of EOA remains controversial and some studies have suggested that the EOA estimated by Doppler-echocardiography (EOA(Dop)) may underestimate the actual EOA at low flow rates. METHODS: One bioprosthetic valve and three rigid orifices were tested in a mock flow circulation model over a wide range of flow rates. The EOA(Dop) was compared with reference values obtained using particle image velocimetry (EOA(PIV)). RESULTS: There was excellent agreement between EOA(Dop) and EOA(PIV) (r2 = 0.94). For rigid orifices of 0.5 and 1.0 cm2, no significant change in the EOA was observed with increasing flow rate. However, substantial increases of both EOA(Dop) and EOA(PIV) were observed when stroke volume increased from 20 to 70 ml both in the 1.5 cm2 rigid orifice (+52% for EOA(Dop) and +54% for EOA(PIV)) and the bioprosthetic valve (+62% for EOA(Dop) and +63% for EOA(PIV)); such changes are explained either by the presence of unsteady effects at low flow rates and/or by an increase in valve leaflet opening. CONCLUSIONS: The flow-dependent changes in EOA(Dop) are not artifacts but represent real changes in EOA attributable either to unsteady effects at low flow rates and/or to changes in valve leaflet opening. Such changes in EOA(Dop) can be relied on for clinical judgment making. |
| Databáze: | OpenAIRE |
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