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Cool white, Ultralume, and Vita-Lite fluorescent lamps for use in color vision testing.

Thirty-one normal and 20 color vision-deficient persons were tested with the Hardy-Rand-Rittler (HRR) Pseudoisochromatic Plates, Farnsworth's D-15 and 100-Hue tests, and the Davidson & Hemmendinger (D & H) Color Rule using Vita-Lite, Ultralume, and Cool White fluorescent lamps to determine their usefulness for color vision measurement. The persons with deficient color vision were classified with a Nagel anomaloscope. The Macbeth Easel lamp was the reference for determining relative lamp performance. No normal was misclassified with any of the lamps. Scores with the Vita-Lite lamp were qualitatively and quantitatively most similar to those with the Macbeth lamp. The Ultralume gave intermediate results, and the Cool White was the least satisfactory substitute. Norms for the metameric D & H Color Rule for each lamp were different, which prevented intercomparisons. Best separation of the scores of deficient from normal persons with the D & H Rule occurred with the Macbeth and Vita-Lite lamps. Better performance with the Vita-Lite and Ultralume lamps can be expected from protans with the HRR and 100-Hue Tests and poorer performances from deutans on the HRR tests than with the standard Macbeth Lamp. The Cool White lamp was judged an unsuitable substitute for color vision testing.

Adolescent↗

Colorimetric analyses of various light sources for the D-15 color vision test.

Colorimetric analyses were performed in both normal trichromatic and dichromatic color spaces to determine whether several light sources were suitable illuminants for the Farnsworth-Munsell Panel D-15 (D-15) color vision test. Results for fluorescent lamps showed that lamps with a correlated color temperature (CCT) of 7200 degrees K and a general color rendering index (GCRI) of at least 90 are acceptable substitutes for illuminant C. Predictions for filtered tungsten light indicated that lights with a color temperature near 5000 degrees K are unsuitable because of nonuniformities in the glass daylight filter transmittance. Conclusions based on these analyses are conservative because, with exception of the GCRI, color adaptation effects were not taken into account.

Adaptation, Ocular↗

Testing color discrimination without the use of special stimuli or technical equipment.

Recently a number of self-report inventories have been developed to provide quick, valid, and reliable measures of sensory function without the use of technical equipment. One such measure, the 10-item Color Screening Inventory, was developed to detect individuals with deficient color perception. In the present study we used a sample of 268 subjects who were tested on both the Farnsworth-Munsell 100-hue test and the Color Screening Inventory. Analysis showed that inventory scores also predict continuous variations in and individuals' ability to discriminate colors, with an eta of .69, which explains 48% of the predictive variance. It was possible to describe the data using a quadratic regression equation which has a corrected correlation of .52. Using this, a conversion table was generated to allow rapid estimation of 100-hue test scores from the inventory. On the basis of the results, the Color Screening Inventory appears to be a quick and effective means of testing color discrimination without requiring special stimuli, technical equipment, or controlled testing environments.

Adult↗

Research note: a multidimensional scaling comparison of color metrics for response times and rated dissimilarities.

Individual-differences multidimensional scaling was applied to a set of proximity data for equiluminant lights (Paramei & Cavonius, 1999) to explore any differences between two data collection procedures (rated dissimilarities, and same/different response times [RTs]), as well as between color-normal and abnormal observers. Two conclusions emerged: (1) The pattern of similarities from observers with anomalous color vision can be understood in terms of a compressed color plane (the weighted Euclidean model of individual differences); and (2) there is evidence that the color "plane" is either curved or governed by a non-Euclidean distance function. When color-normal observers are examined in the weighted-Euclidean framework, minor differences emerge between RT and rating data. But the main distinguishing feature of RT data is a pattern of decreasing accuracy for larger color distances. This must be taken into account, since it can itself induce curvature.

Color Perception↗

Color vision in diabetic school children.

The color vision of 64 diabetic school children was studied. Acquired color vision defects due to diabetes could not be found in any of the children. Two of the children had a congenital red-green color vision defect. In the examination, three different pseudoisochromatic plate tests (Isihara, Standard Pseudoisochromatic Plates part 2, and Lanthony Tritan Album) were used as well as the Nagel anomaloscope and three different cap arrangement tests (Panel D 15, Lanthony Desaturated Panel, and Farnsworth-Munsell 100 hue). The plate tests and the anomaloscope examination were fast, reliable, and well accepted by the children. The cap arrangement tests took more time, and many of the children neither liked nor properly performed these tests. Twelve color dependent glucose strip tests for diabetes care at home were also studied. A few of the youngest school children made mistakes in interpreting the colors of these strips, although their color vision was normal.

Adolescent↗

[Individual variations in color vision and its molecular biology].

Individual variations in normal color vision and congenital red-green color vision defects in Japanese males were investigated using both psychophysics and molecular biology techniques. 1. Normal color vision. We studied 72 Japanese males who were diagnosed as having normal color vision using the Ishihara plates test and Nagel model I anomaloscope. The structure of the gene arrays of the X-linked L- and M-pigment genes was determined using quantitative PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism). We found the following variations of the number of M-pigment genes: 27 (38%) of these men had only one M-pigment gene, 29 (40%) had two, 13 (18%) had three and 3 (4%) had four. Two common polymorphisms were found at amino acid residue 180 of both L- and M-opsin, of the total 56 (78%) were Ser and the other 16 (23%) were Ala in the L-pigment and of the total 65 (90%) were Ala and the other 7 (10%) were Ser in the M-pigment. The Rayleigh match midpoints fell within the normal range, however there were two fairly distinct groups with consistent differences in each group. The mean values of the proportion of red in a mixture of red and green were 0.564 +/- 0.026 (mean +/- standard deviation). Correlation was found only between the Rayleigh match midpoint and the polymorphism at residue 180 of L-pigment. In order to estimate the variations of L/M cone ratio in the retinae the spectral sensitivities using heterochromatic flicker method were measured. Using the hypothesis that the luminosity function is proportional to the sum of L- and M-cone spectral sensitivity (k L (lambda) + M (lambda)), the constant k values were obtained. The k values for the subjects with Ser180 and Ala180 L-pigment were 1.89 +/- 1.44 and 1.85 +/- 1.02 respectively. Furthermore, in order to study the variation of information processing system, the spectral sensitivities for 1 degree, 200-ms test flash on a white background were measured. Using the hypothesis that the spectral sensitivity is proportional to the difference of L- and M-cone spectral sensitivity (L (lambda) - k' M (lambda)), the k' values were obtained. The k' values for the subjects with Ser180 and Ala180 L-pigment were 1.38 +/- 0.06 and 1.49 +/- 0.07 respectively. As a result, it was suggested that there are individual variations in both the L/M cone ratio and the color opponent system. 2. Congenital red-green color vision deficiencies. We studied the structure of the gene arrays of the X-linked L- and M-pigment genes and investigated the relationship between genotype and phenotype in 21 Japanese males comprising 4 protanopia, 6 protanomaly, 7 deuteranopia and 4 deuteranomaly. All of the protan subjects had 5' L-M fusion gene with/without the M gene. All of the deutan subjects had a normal L gene with/without 5' M-L fusion gene. Genotype agreed with phenotype in 8 of 10 protan subjects and 10 of 11 deutan subjects. Two of them were diagnosed as abnormal trichromatism in spite of having only one gene. One of them was diagnosed as dichromatism in spite of having two genes that encoded spectrally different pigments. As a result, it was felt that the diagnosis of dichromacy and abnormal trichromacy with an anomaloscope has limitations.

Asian People↗

[Theoretical patterns of the panel D-15 test in congenital dichromatic color vision defects].

In order to study the theoretical patterns of the panel D-15 test for congenital dichromatic color vision defects, the spectral reflectance for the 16 color caps of the panel D-15 test was measured with a spectro-photometer. Then, the chromaticity-coordinates of each color cap were calculated using the spectral distribution of standard illuminant C. The theoretical patterns of the panel D-15 test for dichromats were obtained based on the confusion lines. For this procedure, the slope of the line between the color cap and the convergence point on the CIE chromaticity diagram was obtained first. Then, the order of the arrangement was decided starting with the slope having the smallest cap number and continuing progressively. For the chromaticity coordinates of the convergence points the following values were used; x = 0.7465, y = 0.2535 for protanopia, x = 1.08, y = -0.08, x = 1.40, y = -0.40, and x = 1.70, y = -0.70 for deuteranopia, and x = 0.171, y = 0.000 for tritanopia. The results show a very clear similarity between the orientation axis obtained by simulation and the actual data. Therefore, it was confirmed that dichromats arrange the color caps in the order of the slope of the line between the color cap and the convergence point, when performing the panel D-15 test. Furthermore, it was suggested that the patterns of the panel D-15 test differ by the convergence points among dichromats even of the same type.

Color Perception↗

Recognition performance of subjects with color-vision deficiencies on a polychromatic sonar screen for ship navigation.

To facilitate differentiation between objects that are approaching, stationary, and moving away, these objects are represented in different colors on the screens of sonar locating devices used in ship navigation. Yellow represents stationary objects, and represents approaching objects, and green represents those objects moving away. A total of 46 subjects with normal color vision and 184 individuals with color-vision deficiencies, among them 29 deuteranopic, 100 deuteranomalous, 21 protanopic and 34 protanomalous individuals, were investigated for their ability to identify different signals. Ten different objects were presented for a period of 64 s each. As a minimal requirement it was established that 50% of the respective experimental group be capable of recognizing the objects within half of this time. Whereas 73.3% of the subjects with normal color vision could meet this requirement, none of the subjects in the different groups with color-vision deficiencies could do so. Only 16.1% of the deuteranopic subjects, 33.1% of the deuteranomalous individuals, 16.2% of the protanopic subjects, and 37.6% of the protanomalous individuals detected all objects within 32 s. No appreciable difference in the ability to recognize signals occurred among the different groups of subjects with color-vision deficiencies.

Color Perception↗

The evolution of human skin coloration.

Skin color is one of the most conspicuous ways in which humans vary and has been widely used to define human races. Here we present new evidence indicating that variations in skin color are adaptive, and are related to the regulation of ultraviolet (UV) radiation penetration in the integument and its direct and indirect effects on fitness. Using remotely sensed data on UV radiation levels, hypotheses concerning the distribution of the skin colors of indigenous peoples relative to UV levels were tested quantitatively in this study for the first time. The major results of this study are: (1) skin reflectance is strongly correlated with absolute latitude and UV radiation levels. The highest correlation between skin reflectance and UV levels was observed at 545 nm, near the absorption maximum for oxyhemoglobin, suggesting that the main role of melanin pigmentation in humans is regulation of the effects of UV radiation on the contents of cutaneous blood vessels located in the dermis. (2) Predicted skin reflectances deviated little from observed values. (3) In all populations for which skin reflectance data were available for males and females, females were found to be lighter skinned than males. (4) The clinal gradation of skin coloration observed among indigenous peoples is correlated with UV radiation levels and represents a compromise solution to the conflicting physiological requirements of photoprotection and vitamin D synthesis. The earliest members of the hominid lineage probably had a mostly unpigmented or lightly pigmented integument covered with dark black hair, similar to that of the modern chimpanzee. The evolution of a naked, darkly pigmented integument occurred early in the evolution of the genus Homo. A dark epidermis protected sweat glands from UV-induced injury, thus insuring the integrity of somatic thermoregulation. Of greater significance to individual reproductive success was that highly melanized skin protected against UV-induced photolysis of folate (Branda & Eaton, 1978, Science201, 625-626; Jablonski, 1992, Proc. Australas. Soc. Hum. Biol.5, 455-462, 1999, Med. Hypotheses52, 581-582), a metabolite essential for normal development of the embryonic neural tube (Bower & Stanley, 1989, The Medical Journal of Australia150, 613-619; Medical Research Council Vitamin Research Group, 1991, The Lancet338, 31-37) and spermatogenesis (Cosentino et al., 1990, Proc. Natn. Acad. Sci. U.S.A.87, 1431-1435; Mathur et al., 1977, Fertility Sterility28, 1356-1360).As hominids migrated outside of the tropics, varying degrees of depigmentation evolved in order to permit UVB-induced synthesis of previtamin D(3). The lighter color of female skin may be required to permit synthesis of the relatively higher amounts of vitamin D(3)necessary during pregnancy and lactation. Skin coloration in humans is adaptive and labile. Skin pigmentation levels have changed more than once in human evolution. Because of this, skin coloration is of no value in determining phylogenetic relationships among modern human groups.

Adaptation, Physiological↗

The utility of echocardiography in the diagnostic strategy of postinfarction ventricular septal rupture: a comparison of two-dimensional echocardiography versus Doppler color flow imaging.

The diagnostic accuracy of Doppler color flow imaging in the diagnosis of postinfarction ventricular septal defects has not been established. In this study, 43 patients with unexplained hypotension or a new murmur in the periinfarct period were evaluated with conventional two-dimensional echocardiography and Doppler color flow imaging. The presence of a ventricular septal defect was confirmed by oximetry, ventriculography, operative repair, or autopsy in each case. Both two-dimensional and Doppler color flow imaging were 100% specific in excluding a ventricular septal defect. Doppler color flow imaging correctly identified the 12 confirmed ventricular septal defects in this study (100% sensitivity), whereas any combination of two-dimensional criteria only correctly identified seven (58% sensitive) (p less than 0.05). Doppler color flow imaging is superior to conventional two-dimensional imaging in the diagnosis of a postinfarction ventricular septal defect. In addition, Doppler color flow imaging localized the septal defect, and thus guided therapy and technique for repair. Carefully performed Doppler color flow examination can exclude or result in the rapid diagnosis of a ventricular septal defect, which eliminates the need for further time-consuming confirmatory testing.

Aged↗

Accuracy of flow convergence estimates of mitral regurgitant flow rates obtained by use of multiple color flow Doppler M-mode aliasing boundaries: an experimental animal study.

The proximal flow convergence method of multiplying color Doppler aliasing velocity by flow convergence surface area has yielded a new means of quantifying flow rate by noninvasively derived measurements. Unlike previous methods of visualizing the turbulent jet of mitral regurgitation on color flow Doppler mapping, flow convergence methods are less influenced by machine factors because of the systematic structure of the laminar flow convergence region. However, recent studies have demonstrated that the flow rate calculated from the first aliasing boundary of color flow Doppler imaging is dependent on orifice size, flow rate, aliasing velocity and therefore on the distance from the orifice chosen for measurement. In this study we calculated the regurgitant flow rates acquired by use of multiple proximal aliasing boundaries on color Doppler M-mode traces and assessed the effect of distances of measurement and aliasing velocities on the calculated regurgitant flow rate. Six sheep with surgically induced mitral regurgitation were studied. The distances from the mitral valve leaflet M-mode line to the first, second, and third sequential aliasing boundaries on color Doppler M-mode traces were measured and converted to the regurgitant flow rates calculated by applying the hemispheric flow equation and averaging instantaneous flow rates throughout systole. The flow rates that were calculated from the first, second, and third aliasing boundaries correlated well with the actual regurgitant flow rates (r = 0.91 to 0.96). The mean percentage error from the actual flow rates were 151% for the first aliasing boundary, 7% for the second aliasing boundary, and -43% for the third aliasing boundary; and the association between aliasing velocities and calculated flow rates indicates an inverse relationship, which suggests that in this model, there were limited velocity-distance combinations that fit with a hemispheric assumption for flow convergence geometry. The second aliasing boundary with an aliasing velocity, of 102 cm/sec, (which was achieved by use of a 4 kHz pulse repetition frequency, a 3.75 MHz transducer, and no color baseline shift), provided the closest fit to the actual regurgitant flow rates (r = 0.99; y = 0.95x + 0.07). The averaged calculated flow rates from all aliasing velocities also resulted in excellent correlation (r = 0.97; y = 0.99x + 0.5). A hemispheric flow convergence method that is based on color Doppler M-mode echocardiography is a feasible and automatable method for quantifying mitral regurgitant rate.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Usefulness of color Doppler flow imaging to distinguish ventricular septal defect from acute mitral regurgitation complicating acute myocardial infarction.

Several studies have found 2-dimensional echocardiography and conventional spectral Doppler ultrasound useful in the assessment of ventricular septal defect (VSD), but few data exist regarding the usefulness of color Doppler flow imaging in evaluating this problem. Thus, the results of color flow imaging performed in 14 patients who presented with a recent acute myocardial infarction (AMI), hemodynamic instability and a new systolic murmur were evaluated. All patients underwent cardiac catheterization for definitive diagnosis, which proved to be VSD in 7 and acute mitral regurgitation in 7. VSD, identified by turbulent flow traversing the ventricular septum during ventricular systole, was correctly identified in all 7 patients with septal rupture. In the remaining 7 patients with a new murmur after AMI, mitral regurgitation was demonstrated as turbulent systolic flow in the left atrium by both color flow imaging and cine ventriculography. In all 14 patients with new murmurs, color flow imaging was 100% accurate for the presence or absence of VSD. Color flow imaging localized the septal defect to the apical septum (3), inferior septum (3) or both inferior and apical septal regions (1), and was 100% concordant for location compared with cineangiography, surgery and conventional Doppler echocardiographic techniques. Color flow imaging was accurate in identifying the presence and location of VSD complicating AMI, and accurately differentiated VSD from mitral regurgitation. Color flow imaging provides safe, rapid diagnosis of VSD complicating AMI, and may alleviate the need for diagnostic right-sided heart catheterization and preoperative cine ventriculography in these seriously ill patients.

Aged↗

A quantitative comparison of transesophageal and epicardial color Doppler echocardiography in the intraoperative assessment of mitral regurgitation.

Epicardial and transesophageal color Doppler echocardiography are both widely used for the intraoperative assessment of mitral regurgitation (MR); however, it has not been established whether grading of regurgitation is comparable when evaluated by these 2 techniques. MR jet size was quantitatively compared in 29 hemodynamically and temporally matched open-chest epicardial and transesophageal color Doppler echocardiography studies from 22 patients (18 with native and 4 with porcine mitral valves) scheduled to undergo mitral valve repair or replacement. Jet area, jet length and left atrial area were analyzed. Comparison of jet area measurements as assessed by epicardial and transesophageal color flow mapping revealed an excellent correlation between the techniques (r = 0.95, p less than 0.001). Epicardial and transesophageal jet length measurements were also similar (r = 0.77, p less than 0.001). Left atrial area could not be measured in 18 transesophageal studies (62%) due to foreshortening, and in 5 epicardial studies (17%) due to poor image resolution. Acoustic interference with left atrial and color flow mapping signals was noted in all patients with mitral valve prostheses when imaged by epicardial echocardiography, but this did not occur with transesophageal imaging. Thus, in patients undergoing valve repair or replacement, transesophageal and epicardial color flow mapping provide similar quantitative assessment of MR jet size. Jet area to left atrial area ratios have limited applicability in transesophageal color flow mapping, due to foreshortening of the left atrial borders in transesophageal views. Transesophageal color flow mapping may be especially useful in assessing dysfunctional mitral prostheses due to the lack of left atrial acoustic interference.

Adult↗

Usefulness of color-flow Doppler in diagnosing and in differentiating supracristal ventricular septal defect from right ventricular outflow tract obstruction.

Color-flow Doppler is used for special localization of cardiac flows. The transeptal jet in supracristal ventricular septal defect (VSD) is directed toward the pulmonary valve and is often difficult to distinguish from the right ventricular (RV) outflow tract flow. Pulsed- and continuous-wave Doppler can misread the VSD jet as a stenotic lesion in the RV outflow tract. This study describes the color-flow Doppler characteristics of supracristal VSD and determines if color-flow Doppler can differentiate supracristal VSD jets from RV outflow tract flow. The study group comprised 28 patients ranging in age from 3 days to 23 years (mean 6.4), with catheter-diagnosed supracristal VSD in 14, isolated pulmonary valve stenosis in 10 and RV infundibular obstruction in 4. The echocardiographic Doppler and color-flow Doppler data of all patients were reviewed without knowledge of catheterization diagnosis. In all patients with supracristal VSD, color-flow Doppler revealed an abnormal transeptal jet directed toward the pulmonary valve that occurred 5 to 10 ms before RV outflow tract flow was identified. VSD and RV outflow tract jet could be differentiated by pulsed- and continuous-wave Doppler alone in 10 of 14 patients (71%). In 4 patients, differentiation was possible only with color-flow Doppler and electrocardiographic gating. Associated aortic regurgitation, or a fistula, or both, were detected in 6 patients. Pulsed- and continuous-wave Doppler with or without color-flow Doppler correctly identified the level of obstruction in all patients with RV outflow tract lesions (14 of 14). Supracristal VSD jet occurs in early systole and is directed toward the pulmonary valve.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Colored collagen is a long-lasting point marker for small pulmonary nodules in thoracoscopic operations.

BACKGROUND: To locate small deep pulmonary nodules under thoracoscopy, we developed a long-lasting point marker termed "colored collagen." METHODS: Colored collagen is composed of 0.8% atelocollagen, 5% methylene blue, and 32% contrast medium. The affinity between atelocollagen and methylene blue was examined in a washing test using 2 mol/L of NaCl. For clinical application, a computed tomography-guided colored collagen injection was performed in 11 patients to localize 11 deep pulmonary nodules, which were less than 20 mm in diameter. RESULTS: The washing test showed that atelocollagen and methylene blue combined with each other firmly. An experimental study using rabbit lung showed that the colored collagen stayed at the injected site for 10 days without toxicity. In clinical application, the colored collagen could be seen as a clear spot using the thoracoscopy 1 to 4 days after the injection in all of the 11 pulmonary nodules. There was no complication except for a slight pneumothorax in 2 patients. CONCLUSIONS: The colored collagen, because it stays in the injected site for a long time, solves the problem of the single dye injection method, which requires both a computed tomographic scan and an operating room simultaneously, and also the colored collagen, because of its point dyeing, can mark the nodule more accurately than a single dye.

Adult↗

Temperature-dependent ultrasound color flow Doppler imaging in the study of a VX2 tumor in rabbits: preliminary findings.

Neovascularity in a VX2 carcinoma in rabbit liver was detectable, using an ultrasonic color Doppler flow imager. Intraportal infusion of heated saline increased the fractional area of color flow Doppler signals by at least 5% and as much as 30%, within and surrounding the tumors of all six rabbits studied. The effect of the fluid load was an increase in fractional area of color flow Doppler signals by 5 to 20% and was determined by the measurements following infusion and return to baseline temperature. The largest increment in color Doppler signal was observed in peritumoral vessels (10-40%). In contrast, the fractional area of color-coded pixels within the tumor was only slightly higher or lower (5-10%) at the peak temperature than at the baseline measurements. The temperature within the tumors was as much as 1 degree lower than parenchymal tissue in all animals measured. This was presumably due to the portal vein blood supply to normal tissue and predominantly hepatic artery supply to the pathological tissue. High velocities and persistent bidirectional flow were observed within the tumors only at the peak temperatures (> 43.5 degrees C). This experiment suggests that thermal stress may enhance tumor detectability by color Doppler imaging. Further development of a quantitative analysis method for color Doppler studies is needed.

Animals↗

Doppler color flow mapping of simulated in vitro regurgitant jets: evaluation of the effects of orifice size and hemodynamic variables.

The spatial distribution of simulated regurgitant jets imaged by Doppler color flow mapping was evaluated under constant flow and pulsatile flow conditions. Jets were simulated through latex tubings of 3.2, 4.8, 6.35 and 7.9 mm by varying flow rates from 137 to 1,260 cc/min. Color jet area was linearly related to flow rate at each orifice (r = 0.96, SEE = 3.4; r = 0.99, SEE = 1.6; r = 0.97, SEE = 2.3; r = 0.97, SEE = 3.2, respectively), but significantly higher flow rates were required to maintain the same maximal spatial distribution of the jet at the larger regurgitant orifices. Constant flow jets were also simulated through needle orifices of 0.2, 0.5 and 1 mm, with a known total volume (5 cc) injected at varying flow rates and with differing absolute volumes injected at the same flow rate (0.2, 1.0 and 2.0 cc/s, respectively). Again, maximal color jet area was linearly related to flow rate at each orifice (r = 0.97, SEE = 2.3; r = 0.97, SEE = 2.4; r = 0.92, SEE = 3.9, respectively), but was not related to the absolute volume of regurgitation. Color encoding of regurgitant jets on Doppler color flow maps was demonstrated to be highly dependent on velocity and, hence, driving pressure, such that color encoding was obtained from a constant flow jet injected at a velocity of 4 m/s through an orifice of 0.04 mm diameter with flow rates as low as 0.008 cc/s. Mitral regurgitant jets were also simulated in a physiologic in vitro pulsatile flow model through three prosthetic valves with known regurgitant orifice sizes (0.2, 0.6 and 2.0 mm2). For each regurgitant orifice size, color jet area at each was linearly related to a regurgitant pressure drop (r = 0.98, SEE = 0.15; r = 0.97, SEE = 0.20; r = 0.97, SEE = 0.23, respectively), regurgitant stroke volume (r = 0.77, SEE = 0.55; r = 0.94, SEE = 0.30; r = 0.91, SEE = 0.41, respectively) and peak regurgitant flow rate (r = 0.98, SEE = 0.16; r = 0.97, SEE = 0.21; r = 0.93, SEE = 0.37, respectively), but the spatial distribution of the regurgitant jets was most highly dependent on the regurgitant pressure drop. Jet kinetic energy calculated from the summation of the individual pixel intensities integrated over the jet area was closely related to driving pressure (r = 0.84), but integration of the power mode area times pixel intensities provided the best estimation of regurgitant stroke volume (r = 0.80).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Doppler color flow mapping in the evaluation of prosthetic mitral and aortic valve function.

Doppler color flow mapping and color-guided conventional Doppler studies were performed on 119 patients with 126 prosthetic valves (mitral alone in 60, aortic alone in 52 and both mitral and aortic in 7 patients) within 2 weeks of the catheterization study or surgery, or both. The mean pressure gradients derived by color-guided continuous wave Doppler ultrasound correlated well with those obtained at catheterization for both the tissue and mechanical mitral and aortic prostheses (r = 0.85 to 0.87). For the effective prosthetic orifice areas, better correlation with catheterization results were obtained with the tissue mitral (r = 0.94) and tissue aortic (r = 0.87) prostheses than with the mechanical mitral (r = 0.79) and mechanical aortic (r = 0.76) prostheses. The maximal width of the color flow signals at their origin from the tissue mitral prostheses also correlated well with the effective prosthetic orifice area at catheterization (r = 0.81). Doppler color flow mapping identified prosthetic valvular regurgitation with a sensitivity and specificity of 89% and 100%, respectively, for the mitral and 92% and 83% for the aortic prostheses. There was complete agreement between the Doppler color flow mapping and angiographic grading of the severity of prosthetic valvular regurgitation in 90% of mitral and 73.5% of the aortic regurgitant prostheses with under- or overestimation by greater than 1 grade in only two cases. Valvular and paravalvular regurgitation was correctly categorized by Doppler color flow mapping in relation to the surgical findings in 94% of the mitral and 80.5% of the aortic prostheses.

Adult↗