Cath pressure tracings are acquired from chambers which relative to the stenotic/regurgitant valve to provide peak-to-peak gradients?

• A. Proximal and Distal
• B. Proximal and Adjacent
• C. Superior and Inferior
• D. Anterior and Posterior

Answer: (A)

The main idea is that the pressure gradient across a valve is found by taking pressures from the two chambers on opposite sides of that valve. In catheter terms, one is upstream (proximal) to the valve and the other is downstream (distal). Measuring the peak pressure on each side and subtracting gives the peak-to-peak gradient. For example, with aortic stenosis you compare the left-ventricular pressure (proximal to the aortic valve) with the aortic pressure (distal). In mitral-area disease you compare the left atrial pressure (proximal) with the left ventricular pressure (distal). The other descriptors don’t specify the two sides across the valve, so they don’t define the gradient accurately.