Circulation, Vol 74, 306-314, Copyright © 1986 by American Heart Association
S Blumlein, A Bouchard, NB Schiller, M Dae, BF Byrd 3d, T Ports and EH Botvinick
The evaluation and care of patients with mitral regurgitation would be
facilitated by an easy, reproducible and noninvasive method that could
quantitate the hemodynamic burden. In this study, we describe a new Doppler
echocardiographic method that measures the regurgitant fraction and we
compare it with angiographic and scintigraphic methods. A total of 27
patients with mitral regurgitation were evaluated by echocardiography and
either cardiac catheterization or scintigraphy. With two-dimensional
echocardiography, diastolic and systolic volumes were measured to derive
the left ventricular stroke volume (LVSV). The forward stroke volume (FSV)
was obtained from the product of M mode- derived aortic valve area and
ascending aortic flow velocity integral assessed by continuous-wave
Doppler. Regurgitant fraction was calculated as follows: (LVSV - FSV)/LVSV.
Comparisons showed that regurgitant fraction calculated by Doppler
echocardiography correlated with regurgitant fraction determined by both
cardiac catheterization (r = .82) and by scintigraphy (r = .89). There was,
however, an important interobserver variability within each method: 10%,
13%, and 11% for Doppler echocardiography, angiography, and scintigraphy,
respectively. In conclusion, Doppler echocardiography can be used to
quantitate mitral regurgitation. Serial noninvasive determinations of
regurgitant fraction may be useful in the evaluation of therapy and in the
follow- up of patients with mitral insufficiency.
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Quantitation of mitral regurgitation by Doppler echocardiography
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