Usefulness of the doppler mean gradient in evaluation of children with aortic valve stenosis and comparison to gradient at catheterization
dc.contributor.author | Bengur, A. Resai | en_US |
dc.contributor.author | Snider, A. Rebecca | en_US |
dc.contributor.author | Serwer, Gerald A. | en_US |
dc.contributor.author | Peters, Jane | en_US |
dc.contributor.author | Rosenthal, Amnon | en_US |
dc.date.accessioned | 2006-04-07T20:41:25Z | |
dc.date.available | 2006-04-07T20:41:25Z | |
dc.date.issued | 1989-10-01 | en_US |
dc.identifier.citation | Bengur, A. Resai, Snider, A. Rebecca, Serwer, Gerald A., Peters, Jane, Rosenthal, Amnon (1989/10/01)."Usefulness of the doppler mean gradient in evaluation of children with aortic valve stenosis and comparison to gradient at catheterization." The American Journal of Cardiology 64(12): 756-761. <http://hdl.handle.net/2027.42/27748> | en_US |
dc.identifier.uri | http://www.sciencedirect.com/science/article/B6T10-4C709B5-XN/2/2cdee4a32d95c4b4d508e951d5b9cdfa | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/27748 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=2801526&dopt=citation | en_US |
dc.description.abstract | To assess the usefulness of the Doppler mean gradient as a noninvasive indicator of the need for intervention, 33 children (ages 3 months to 20 years) with valvular aortic stenosis (AS) underwent a 2-dimensional and Doppler echocardiographic examination a median of 1 day before cardiac catheterization. The clinical decision for intervention was based on finding a catheterization peak-to-peak pressure gradient of >75 mm Hg or from 50 to 75 mm Hg in the presence of symptoms or an abnormal exercise treadmill test result. Of the 33 patients, 23 required intervention. The decision for intervention was compared to the Doppler mean gradient, and the Doppler peak and mean gradients were compared to the catheterization peak-to-peak gradient. All 12 patients with a Doppler mean gradient >27 mm Hg had intervention and had a catheterization peak-to-peak gradient of >75 mm Hg. All 3 patients with a Doppler mean gradient From a chi-square table, a Dopppler mean gradient >27 mm Hg predicted the need for intervention with 100% specificity (no false positives) and 52% sensitivity (11 false negatives). if a Doppler mean gradient >24 mm Hg was used to predict intervention, the sensitivity increased to 91% (2 false negatives) but specificity decreased to 70% (3 false positives). To improve the ability to predict the need for intervention in patients with a Doppler mean gradient between 17 and 27 mm Hg, the presence of symptoms or an abnormal exercise treadmill test result was combined with the Doppler mean gradient as criteria for intervention. When the criteria for intervention were a Doppler mean gradient >27 mm Hg or a Doppler mean gradient from 17 to 27 mm Hg in the presence of symptoms or an abnormal exercise test, sensitivity was 96% (1 false negative) and specificity was 80% (2 false positives). Catheterization peak-to-peak gradients correlated well with Doppler mean and peak gradients (r = 0.74 and 0.73, respectively).Thus, the Doppler mean gradient is a useful indicator of the need for intervention in children with AS. A Doppler mean gradient >27 mm Hg indicates the need for intervention with 100% specificity while a Doppler mean gradient < 17 mm Hg predicts mild AS. For patients with Doppler mean gradient between 17 and 27 mm Hg, additional noninvasive data are necessary to determine the need for intervention. | en_US |
dc.format.extent | 597827 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | en_US |
dc.title | Usefulness of the doppler mean gradient in evaluation of children with aortic valve stenosis and comparison to gradient at catheterization | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Pediatrics, C.S. Mott Children's Hospital,University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Department of Pediatrics, C.S. Mott Children's Hospital,University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Department of Pediatrics, C.S. Mott Children's Hospital,University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Department of Pediatrics, C.S. Mott Children's Hospital,University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Department of Pediatrics, C.S. Mott Children's Hospital,University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.identifier.pmid | 2801526 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/27748/1/0000140.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1016/0002-9149(89)90760-1 | en_US |
dc.identifier.source | The American Journal of Cardiology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.