Non-invasive estimation of pressure gradients across a coarctation of the aorta (CoA) can reduce the need for diagnostic cardiac catheterisation. We aimed to validate two novel computational strategies—target-value approaching (TVA) and target-value fixing (TVF)—together with unrefined Doppler estimates, and to compare their diagnostic performance in identifying critical pressure drops for 40 patients. Compared to catheterisation, no statistically significant difference was demonstrated with TVA (P = 0.086), in contrast to TVF (P = 0.005) and unrefined Doppler echocardiography (P < 0.001). TVA manifested the strongest correlation with catheterisation (r = 0.93), compared to TVF (r = 0.83) and echocardiography (r = 0.67) (all P < 0.001). In discriminating pressure gradients greater than 20 mmHg, TVA, TVF, and echocardiography had respective sensitivities of 0.92, 0.88, and 0.80; specificities of 0.93, 0.80, and 0.73; and AUCs of 0.96, 0.89, and 0.80. The TVA strategy may serve as an effective and easily implemented approach to be used in clinical management of patients with CoA.

通过主动脉缩窄 (CoA) 的压力梯度的非侵入性估计可以减少诊断性心导管插入术的需要。我们的目的是验证两种新颖的计算策略——目标值逼近 (TVA) 和目标值固定 (TVF)——以及未改进的多普勒估计，并比较它们在识别 40 名患者的临界压降方面的诊断性能。与导管插入术相比，TVA ( P  = 0.086) 与 TVF ( P  = 0.005) 和未改进的多普勒超声心动图 ( P  < 0.001)相比，没有显示出统计学上的显着差异。与 TVF ( r = 0.83) 和超声心动图 ( r  = 0.67)（所有P <  0.001）。在区分大于 20 mmHg 的压力梯度时，TVA、TVF 和超声心动图的灵敏度分别为 0.92、0.88 和 0.80；特异性为 0.93、0.80 和 0.73；AUC 分别为 0.96、0.89 和 0.80。TVA 策略可以作为一种有效且易于实施的方法，用于 CoA 患者的临床管理。