Doppler Hemodynamics

Question 1

how to calculate LAP using MR velocities

Answer 1

LAP = LVP - (4 x MR velocity ^2)

Question 2

how to calculate LAP using PFO

Answer 2

LAP = (4 x PFO velocity ^2) + RAP

Question 3

how to calculate LVDP using AR

Answer 3

LVDP = DBP - (4x AR diastolic velocity ^2)

Question 4

Jae Oh’s eq’n for PVR

Answer 4

PVR = (Vtr/RVOT TVI) x 10 + 0.16

Question 5

name the four parameters to look at for diastolic assessment

Answer 5

E/A e’ (mitral annulus) PASP Pulm vein velocities

Question 6

which one is dependent on PRELOAD: E or E’

Answer 6

E (E’ is NOT dependent on preload. once its reduced in diastolic fxn, nothing increases it)

Question 7

normal e’

Answer 7

>8 cm/s

Question 8

normal LVOT Diameter

Answer 8

2-2.2cm

Question 9

What does this “L-wave” mean? (hint- happens a LOT in afib)

Answer 9

delayed relaxation and increased filling pressures

Question 10

“W” in RVOT velocity indicates?

Answer 10

PH

Question 11

T/F: strain is more sensitive than EF for systolic fxn?

Answer 11

True

Question 12

Normal LVOT TVI

Answer 12

20

Question 13

what PISA radius do you use if you have 2 MR jets at 7mm each?

Answer 13

sq. rt (7^2 + 7^2 ) = sq rt 98 = new PISA radius

Question 14

if you are trying to grade MS severeity and your angle is really off, which of the following is still reliable: Peak velocity, peak gradient or PHT?

Answer 14

PHT

Question 15

when placing PW to measure LVOT TVI, where do you put it?

Answer 15

in blue area (BART) outside of the flow convergence hemisphere

Question 16

MR Flow Rate = (Eq’n)

Answer 16

6.28 x r^2 x Va

Question 17

ERO Eq’n

Answer 17

Flow rate/ MR CW Velocity = 6.28 x r^2 x Va/ Vmax

Question 18

eq’n for MR Regurgitant Vol (RV)

Answer 18

RV = ERO x CW MR TVI

Question 19

in MR, when Aliasing V = 40 cm/s & MR Velocity = 500cm/s, what is eq’n for ERO?

Answer 19

r^2 / 2 , (half the pisa radius squared)

Question 20

when getting aliasing velosity to calculate PISA, which way do you shift the baseline?

Answer 20

in the direction of color jet (“up for up, down for down”)

Question 21

eq’n for MVA by PISA

Answer 21

(6.28 x r^2 x Va)/Vpeak x a/180

(Not MV TVI in denominator like w/ continuity eq’n!!!)

Question 22

with AR, how do you calculate SV?

Answer 22

use MV Area x MV VTI. do NOT use LVOT numbers as they contain both forward and regurgitant flow.

Question 24

eq’n to calculate RV for AR (Doppler hemodynamics workshop- draw your diagrams)

Answer 24

LVOT SV - MV SV

Question 25

eq’n for Regurgitant Fraction (e.g. AR)

Answer 25

RV/LVOT SV= (LVOT SV - MV SV)/LVOT SV

Question 26

in MR, what to do if ERO and RV are discordant?

Answer 26

use RV