Copyright © 1999 by the European Society of Cardiology.
Extent, determinants and clinical importance of pressure recovery in patients with aortic valve stenosis
a Department of Cardiology, University of Tübingen, Tübingen, Germany
b Department of Cardiology, Klinikum Mannheim, University of Heidelberg, Mannheim, Germany
c Department of Cardiology, Klinikum Ludwigshafen, Ludwigshafen, Germany
revised December 14, 1998; accepted December 16, 1998
Abstract
Aims In experimental studies the recovery of pressure distal to stenotic valve orifices has been well described. We evaluated the extent, determinants, and clinical importance of pressure recovery in patients with aortic valve stenosis.
Methods and Results The study was performed in 37 patients with aortic valve stenosis, in whom cardiac catheterization was performed and left ventricular and aortic pressures were determined using a high-fidelity multi-tip micromanometer catheter. To register the pressure waveforms accurately the catheter was positioned so that the proximal micromanometer was in the left ventricle, the second at the site of minimal pressure in the vena contracta, and the third (the most distal) in the ascending aorta 16cm further downstream. The amount of pressure recovery within the ascending aorta was up to 44% of the maximal pressure drop. The index pressure recovery was directly correlated to the Gorlin-derived aortic valve area (r=0·80) and indirectly correlated to the ratio of aortic valve area and the cross-sectional area of the ascending aorta.
Conclusions This clinical study confirmed experimental data, that index pressure recovery is dependent on the ratio of the effective valve area and the cross-sectional area of the ascending aorta. Pressure recovery may need to be considered in patients with mild to moderate aortic stenosis and with a small cross-sectional area of the ascending aorta.
Key Words: Aortic valve stenosis, multi-tip micromanometer catheter, pressure recovery
f1 Correspondence : Dr Wolfgang A. Schöbel, Department of Cardiology, University of Tübingen, Otfried-Müller Straße 10, 72076 Tübingen, Germany.
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