Quantitative assessment by Doppler echocardiography of pulmonary or aortic regurgitation

This study quantitates semilunar valve regurgitation by Doppler measurement of flows. The patients selected had single semilunar valve regurgitation; the other semilunar valve was normal. For the regurgitant valve, forward and reverse flows were measured in the great vessel distal to the abnormal valve, and reverse flow was subtracted from total forward flow to yield net flow. Net flow was compared with forward flow distal to the normal semilunar valve. If all values were computed accurately, net flow should equal forward flow distal to the normal semilunar valve. Twenty patients were studied and 18 had satisfactory recordings. Mean flow in the normal great vessel (3,511 ml/min) was not significantly different from mean net flow in the vessel with the abnormal valve (3,590 ml/min). The correlation coefficient for the paired flow measurements was +0.91 (685 ml [standard error of the estimate]). The slope of the relation was 0.88 and the intercept was 502 ml. Percent regurgitation varied from 29 to 73% and the percentage generally corresponded to clinical estimates. It is concluded that this method, which includes an internal control for each patient, is useful and reasonably accurate for clinical use in patients with pulmonary regurgitation, and appears clinically useful in some patients with aortic regurgitation.