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[The usefulness of continuous Doppler in the diagnosis of aortic coarctation]
1Servicio de Cardiología Pediátrica, Hospital Infantil de Cruces, Vizcaya.
Insights
Continuous wave Doppler ultrasound is a useful diagnostic tool for coarctation of the aorta. Key Doppler curve variables like systolic and diastolic gradients accurately identify this aortic narrowing.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Pediatric Cardiology
Background:
- Coarctation of the aorta is a congenital narrowing of the aorta.
- Accurate diagnosis is crucial for timely intervention and improved patient outcomes.
- Continuous wave Doppler ultrasound offers a non-invasive imaging modality.
Purpose of the Study:
- To assess the diagnostic utility of continuous wave Doppler ultrasound for coarctation of the aorta.
- To identify key Doppler parameters indicative of coarctation.
- To evaluate the sensitivity and specificity of Doppler variables.
Main Methods:
- Studied 32 patients diagnosed with coarctation of the aorta (native and re-coarctation).
- Compared Doppler ultrasound variables from the descending aorta with a control group of 20 healthy individuals.
- Analyzed peak systolic gradient, peak diastolic gradient, systolic velocity half time, diastolic velocity half time, and corrected acceleration time.
Main Results:
- Significant differences (p<0.01) were observed in all studied Doppler variables between patients and controls.
- Peak systolic gradient demonstrated 100% sensitivity and specificity.
- Diastolic gradient and time to half peak diastolic velocity showed high specificity (100%) with good sensitivity (93% and 62%, respectively).
- All patients exhibited at least two altered Doppler variables.
Conclusions:
- Continuous wave Doppler ultrasound is a valuable diagnostic method for coarctation of the aorta.
- Systolic gradient, diastolic gradient, and time to half peak diastolic velocity are the most significant Doppler indicators.
- Doppler parameters effectively differentiate coarctation of the aorta from normal aortic flow.
Abstract:
Were studied 32 patients with coarctation of the aorta by continuous wave Doppler ultrasound in order to assess the usefulness of this diagnostic method. Nineteen (59%) had native coarctation and 13 (41%) recoarctation. Seventeen (53%) were male and 15 (47%) female. The mean age when diagnosis was performed was 56 +/- 54 months. We found associated anomalies in 15 patients (46%). We studied 5 variables of the continuous Doppler curve at the descending aorta that were compared with those of a control group of 20 patients without cardiac anomalies. The variables were: peak systolic gradient (50.1 +/- 18 mmHg; VS 7.6 +/- 3 mmHg; p = 0.001); peak diastolic gradient 18.5 +/- 10 mmHg; VS 0.49 +/- 0.5 mmHg; p = 0.001; systolic velocity half time 151.5 +/- 40 msec; VS 102 +/- 17 msec; p = 0.01; diastolic velocity half time 132.2 +/- 82 msec; VS 7 +/- 14 msec; p = 0.001 corrected acceleration time (169 +/- 26 mmHg; VS 138 +/- 22 mmHg; p = 0.01). Systolic gradient was highly sensitive (100%) and specific (100%). Diastolic gradient and time to half peak diastolic velocity were very specific (100%) and less sensitive (93% and 62%). There were 6 false positive and 4 false negative when we used the time to half peak systolic velocity (sensitivity 81%, specificity 72%). We conclude that continuous Doppler is a useful method in the diagnosis of coarctation of the aorta. The most important variables of Doppler curve are systolic gradient, diastolic gradient and time to half peak diastolic velocity. All patients with coarctation of aorta had at least 2 variables altered.