Key result
Vena contracta width ≥6 mm demonstrated 95% sensitivity and 90% specificity for diagnosing severe aortic regurgitation (effective regurgitant orifice ≥30 mm2).
Why the study?
Does the width of the vena contracta measured by color Doppler imaging accurately assess the severity of aortic regurgitation compared to reference methods?
Observational (n=159)
Does the width of the vena contracta measured by color Doppler imaging accurately assess the severity of aortic regurgitation compared to reference methods?
Effect estimate: r = 0.89
p-value: p=<0.0001
Vena contracta width is a simple and reliable echocardiographic method for assessing the severity of aortic regurgitation, with a width ≥6 mm indicating severe AR.
Supports vena contracta ≥6 mm for severe AR assessment; leaves open prospective validation before routine adoption.
Background —The width of the vena contracta (VC-W), the smallest area of regurgitant flow, reflects the degree of valvular regurgitation and is measurable by color Doppler imaging, but this method has not been validated in aortic regurgitation (AR). Methods and Results —We prospectively examined 79 patients with isolated AR and 80 patients without regurgitation. The VC-W was measured from the long-axis parasternal view and compared with 2 simultaneous reference methods (quantitative Doppler and 2D echocardiography). In patients without regurgitation, the agreement between methods was excellent. In patients with AR, good correlations (all P <0.0001) were obtained between VC-W and effective regurgitant orifice (ERO) area and regurgitant volume recorded by quantitative Doppler ( r =0.89 and 0.90, respectively) and 2D echocardiographic ( r =0.90 and 0.89, respectively) methods. These correlations were similar with eccentric or central jets (all P >0.60). The other methods used showed good correlations of VC-W with aortographic grading of AR (n=8, r =0.82, P =0.01), with the proximal flow convergence method (n=53, r =0.85, P <0.0001), and with left ventricular end-diastolic volume ( r =0.81, P <0.0001). Sensitivity and specificity of VC-W ≥6 mm for diagnosing severe AR (ERO ≥30 mm 2 ) were 95% and 90%, respectively. Conclusions —For assessment of the degree of AR, VC-W shows good correlations with simultaneous quantitative measures (regardless of jet direction), shows good correlations with other methods of assessment of AR, and provides a high diagnostic value for severe AR. VC-W is a simple, reliable method that can be used clinically as part of comprehensive Doppler echocardiographic assessment of AR.
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Tribouilloy et al. (2000) conducted an observational in Aortic Regurgitation (n=159). Vena contracta width (VC-W) measurement vs. Quantitative Doppler and 2D echocardiography was evaluated on Correlation of VC-W with effective regurgitant orifice area by quantitative Doppler (r = 0.89, p=<0.0001). Vena contracta width ≥6 mm demonstrated 95% sensitivity and 90% specificity for diagnosing severe aortic regurgitation (effective regurgitant orifice ≥30 mm2).
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