What is the clinical evidence from this study?

Study design: Observational. Population: Aortic coarctation (n=32). Intervention: Doppler echocardiography vs. Catheterization. Primary outcome: Pressure gradient (r = 0.98, p=NS).

What question did this study set out to answer?

To assess whether Doppler echocardiography can reliably estimate transcoarctation pressure gradients compared with invasive cardiac catheterization.

August 7, 2026Journal of the American College of CardiologyOpen Access

Accuracy and pitfalls of Doppler evaluation of the pressure gradient in aortic coarctation

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Key result

Doppler echocardiography accurately estimates aortic coarctation gradients compared to catheterization with an r of ~0.98.

r = 0.98
P NS
n=32

Why the study?

Does Doppler echocardiography accurately predict the pressure gradient in patients with aortic coarctation compared to cardiac catheterization?

Population

32 patients/studies with aortic coarctation analyzed after excluding 3 neonates with patent ductus arteriosus.

Comparison

Doppler echocardiography to estimate… vs Pressure gradients measured directly at cardiac…

Design

Cross-sectional

Authors

GMGerald R. MarxPediatric Cardiology HAHugh D. AllenPediatric / Congenital Cardiology

Discussion

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Implication

Doppler echocardiography accurately estimates the pressure gradient in aortic coarctation, with improved accuracy when both proximal and distal velocities are included in the modified Bernoulli equation.

Key Points

To assess whether Doppler echocardiography can reliably estimate transcoarctation pressure gradients compared with invasive cardiac catheterization.
Evaluated Doppler echocardiography in 35 studies to calculate transcoarctation pressure gradients against invasive cardiac catheterization measurements in pediatric patients (mean age 6 ± 5.8 years).
Excluded three neonates with coarctation and patent ductus arteriosus due to inadequate Doppler jet velocity recordings, leaving 32 studies for analysis.
Calculated gradients using the modified Bernoulli equation with distal jet velocity alone (V2, n = 32) and with combined pre- and postcoarctation velocities (V1 and V2, n = 26).
Distal velocity alone (V2) estimated a mean Doppler gradient of 44 ± 17 mm Hg versus a catheterization gradient of 36 ± 21 mm Hg (p = NS; r = 0.91, SEE = 7.0 mm Hg; slope = 0.75, y = 17.3 mm Hg).
Incorporating both proximal and distal velocities (V1 and V2) yielded a Doppler-estimated gradient of 36 ± 20 mm Hg versus 36 ± 21 mm Hg for catheterization (p = NS; r = 0.98, SEE = 4.2 mm Hg; slope = 0.91, y = 2.8 mm Hg).

Study Design

Type

Observational (n=32)

Structured PICO

Does Doppler echocardiography accurately predict the pressure gradient in patients with aortic coarctation compared to cardiac catheterization?

Population

32 studies of patients (mean age 6 years) with aortic coarctation undergoing both Doppler echocardiography and catheterization.

Exposure

Doppler echocardiography to estimate transcoarctation pressure gradients using the modified Bernoulli equation (incorporating velocities proximal and distal to the obstruction).

Comparator

Pressure gradients measured directly at cardiac catheterization.

Outcome

Correlation and agreement between Doppler-estimated pressure gradient and catheterization-measured pressure gradient.surrogate

Main Result

Effect estimate: r = 0.98

Absolute Event Rate: 36% vs 36%

p-value: p=NS

Limitations

Jet velocities were not adequately obtained by Doppler recording in three neonates with coarctation and patent ductus arteriosus
Jet velocities were not adequately obtained by Doppler recording in neonates with coarctation and patent ductus arteriosus

Cite This Study

Marx et al. (1986) conducted an observational in Aortic coarctation (n=32). Doppler echocardiography vs. Catheterization was evaluated on Pressure gradient (r = 0.98, p=NS). Doppler echocardiography closely estimated the pressure gradient in aortic coarctation compared to catheterization (mean 36 vs 36 mm Hg; r=0.98) when pre- and postcoarctation velocities were included.

synapsesocial.com/papers/6a75a3028cf48732f0c95f17 https://doi.org/10.1016/s0735-1097(86)80160-7

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Accuracy and pitfalls of Doppler evaluation of the pressure gradient in aortic coarctation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Accuracy and pitfalls of Doppler evaluation of the pressure gradient in aortic coarctation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

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