Ted R. Kohler, M. D. , Stephen C. Nicholls, M. D. , R

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Presentation transcript:

Assessment of pressure gradient by Doppler ultrasound: Experimental and clinical observations Ted R. Kohler, M.D., Stephen C. Nicholls, M.D., R.Eugene Zierler, M.D., Kirk W. Beach, Ph.D., M.D., Peter J. Schubart, M.D. *, D.E. Strandness, M.D. Journal of Vascular Surgery Volume 6, Issue 5, Pages 460-469 (November 1987) DOI: 10.1016/0741-5214(87)90304-1 Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Sample velocity waveform demonstrating peak systolic velocity (A), reverse velocity in diastole (B), and end-diastolic velocity (C). Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Measured pressure gradient vs. measured diameter reduction for one animal experiment. Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Pressure gradient calculated with the Bernoulli equation vs. the measured pressure gradient for one animal experiment. Dotted line indicates perfect agreement. Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Pressure gradient calculated with the Bernoulli equation vs. the measured pressure gradient for the combined animal experiments. Dotted line indicates perfect agreement. Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Group data, pressure gradient calculated with the Bernoulli equation vs. the measured pressure gradient for the combined animal experiments with standard error bars. Dotted line indicates perfect agreement. Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 End-diastolic velocity measured at the site of the stenosis vs. the measured pressure gradient for one animal experiment. Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 7 Combined data for all animal experiments. End-diastolic velocity measured at the site of the stenosis vs. the measured pressure gradient. The linear regression line is included (solid line) as are the 95% confidence limits for the regression of Y on X (dotted lines). Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 8 Pressure gradient calculated with the Bernoulli equation vs. the measured pressure gradient for the clinical data. Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 9 End-diastolic velocity measured at the site of stenosis vs. pressure gradient measured at angiography for the clinical data. Paired data points represent before and after angioplasty for individual patients. Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 10 A, Two pressure waves a short distance apart recorded from a peripheral artery. B, The pressure gradient obtained by subtracting the pressure point at the downstream site from the upstream site, which when positive represents an accelerating force and when negative a decelerating force. (Modified from MacDonald DA. Blood flow in arteries. London: Edward Arnold, 1974:120.) Journal of Vascular Surgery 1987 6, 460-469DOI: (10.1016/0741-5214(87)90304-1) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions