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European Heart Journal 1985 6(10):858-864;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Determination of the mean pressure gradient in mitral stenosis by Doppler echocardiography

Y. ZHANG*,, S. NITTER-HAUGE and E. MYHRE

Medical Department B, Rikshospitalet, University Hospital Oslo, Norway
*Research fellow from the Cardiovascular Institute, Shandong Medical College. People's Republic of China.

Received 6 March 1985; revised 29 May 1985; .

Address for reprints Yun Zhang, M.D, Medical Department B,Rikshospitalet, Pilestredet 32, 0027 Oslo I, Norway.

Abstract

Measurement of the mean pressure gradient provides an important estimation of the severity of mitral stenosis. However, determination of the mean pressure gradient from Doppler recordings has been unsatisfactory using previously described methods. In this study, a new method for calculating the mean pressure gradient, the integral method is described. It was developed from mathematical analysis of Doppler velocity curves. Doppler echocardiography and cardiac catheterisation were performed in 23 patients with mitral stenosis to evaluate the accuracy of three current mathematical methods of determining the mean pressure gradient. The mean pressure gradients calculated by the three methods correlated highly with that measured by catheterisation (r=0.93). However, the mean pressure gradients calculated by the previously described mean velocity square method and the arithmetical average method underestimated significantly that measured by cardiac catheterisation. In contrast, there was no significant difference between the mean pressure gradients calculated by the integral method and measured by cardiac catheterisation. These results confirm the usefulness of Doppler echocardiography for determining the mean pressure gradient in mitral stenosis and demonstrate that among current methods, the integral method provides the most accurate calculations of the mean pressure gradient.

Key Words: Mean pressure gradient • mitral stenosis • Doppler echocardiography


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