Quantifying Aortic Regurgitation by Using the Color Doppler–Imaged Vena Contracta

BACKGROUND: The aim of the present study was to evaluate the accuracy of determining aortic effective regurgitant orifice area (EROA) and aortic regurgitant volume by using the color Doppler-imaged vena contracta (CDVC). METHODS AND RESULTS: Twenty-nine hemodynamically different states were obtained pharmacologically in eight sheep with surgically induced aortic regurgitation. Instantaneous regurgitant flow rates (RFRs) were obtained with aortic and pulmonary electromagnetic flowmeters (EFMs), and aortic EROAs were determined from EFM RFRs divided by continuous wave Doppler velocities. Color Doppler-derived EROAs were estimated by measuring the maximal diameters of the CDVC. Peak and mean RFRs and regurgitant volumes per beat were calculated from vena contracta area continuous wave diastolic Doppler velocity curves. Peak EFM-derived RFRs varied from 1.8 to 13.6 (6.3+/-3.2) L/min (range mean+/-SD), mean RFRs varied from 0.7 to 4.9 (2.7+/-1.3) L/min, regurgitant volumes per beat varied from 7.0 to 48.0 (26.9+/-12.2) mL/beat, and the regurgitant fractions varied from 23% to 78% (55+/-16%). EROAs determined by using CDVC measurements correlated well with reference EROAs obtained by using the EFM method (r=.91, SEE=0.07 cm2). Excellent correlations and agreements between peak and mean RFR and regurgitant volumes per beat as determined by Doppler echocardiography and EFM were also demonstrated (r=.95 to .96). CONCLUSIONS: Our study indicates that the CDVC method can be used to quantify both aortic EROAs and regurgitant flow rates.