The Integration of Doppler Ultrasound With Two-Dimensional Echocardiography and the Noninvasive Cardiac Hemodynamic Revolution of the 1980s

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In the 1970s, as cardiac imaging matured from M-mode to two-dimensional echocardiography, investigators in Norway showed that continuous-wave Doppler ultrasonography could be used to accurately measure the mean gradient and pressure half-time for stenotic mitral valves. In the 1980s, continuous-wave Doppler was validated for measurement of the pressure gradient across stenotic aortic valves, and pulsed-wave Doppler combined with two-dimensional echocardiographic imaging was validated for noninvasive measurement of stroke volume and cardiac output. The combination of stroke volume measurement and measurement of the time-velocity integral of flow through the aortic valve was then validated as a means to accurately calculate valve area for patients with stenotic aortic valves or aortic prostheses. This integration of cardiac Doppler ultrasonography with two-dimensional echocardiographic cardiac imaging led to a revolution in noninvasive hemodynamic evaluations, which have replaced invasive hemodynamic evaluations in surgical decision making for most patients with native or prosthetic valvular stenosis.

Original languageEnglish (US)
JournalJournal of the American Society of Echocardiography
StateAccepted/In press - Jan 1 2018



  • 2D echocardiography
  • Aortic prostheses
  • Aortic stenosis
  • Doppler echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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