Circulation, Vol 75, 175-183, Copyright © 1987 by American Heart Association
F Helmcke, NC Nanda, MC Hsiung, B Soto, CK Adey, RG Goyal and RP Gatewood Jr
We evaluated 147 patients with adequate color Doppler and angiographic
studies for mitral regurgitation. Sixty-five patients had no mitral
regurgitation by both color Doppler and angiography and 82 patients had
mitral regurgitation by both techniques. Thus the sensitivity and
specificity of color Doppler for the detection of mitral regurgitation was
100%. Three two-dimensional echocardiographic planes (parasternal long and
short axis, apical four-chamber view) were used to analyze variables of the
mitral regurgitant jet signals in the left atrium. The best correlation
with angiography was obtained when the regurgitant jet area (RJA) (maximum
or average from three planes) expressed as a percentage of the left atrial
area (LAA) obtained in the same plane as the maximum regurgitant area was
considered. The maximum RJA/LAA was under 20% in 34 of 36 patients with
angiographic grade I mitral regurgitation, between 20% and 40% in 17 of 18
patients with grade II mitral regurgitation, and over 40% in 26 of 28
patients with severe mitral regurgitation. Maximum RJA/LAA also correlated
with angiographic regurgitant fractions (r = .78) obtained in 21 of 40
patients in normal sinus rhythm and with no evidence of associated aortic
regurgitation. Other variables of the regurgitant jet such as maximal
linear and transverse dimensions, maximal area, or maximal area expressed
as a percentage of the LAA in one or two planes correlated less well with
angiography. Color Doppler is a useful noninvasive technique that is not
only highly sensitive and specific in the identification of mitral
regurgitation but also provides accurate estimation of its severity.
ARTICLES
Color Doppler assessment of mitral regurgitation with orthogonal planes
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R. Beinart, V. Boyko, E. Schwammenthal, R. Kuperstein, A. Sagie, H. Hod, S. Matetzky, S. Behar, M. Eldar, and M. S. Feinberg Long-term prognostic significance of left atrial volume in acute myocardial infarction J. Am. Coll. Cardiol., July 21, 2004; 44(2): 327 - 334. [Abstract] [Full Text] [PDF]
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J. Albers, T. Nitsche, J. Boese, R. De Simone, I. Wolf, A. Schroeder, and C. F. Vahl Regurgitant jet evaluation using three-dimensional echocardiography and magnetic resonance Ann. Thorac. Surg., July 1, 2004; 78(1): 96 - 102. [Abstract] [Full Text] [PDF]
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P. L. Temporelli, P. Giannuzzi, G. L. Nicolosi, R. Latini, M. G. Franzosi, F. Gentile, L. Tavazzi, A. P. Maggioni, and GISSI-3 Echo Substudy Investigators Doppler-derived mitral deceleration time as a strong prognostic marker of left ventricular remodeling and survival after acute myocardial infarction: Results of the GISSI-3 Echo substudy J. Am. Coll. Cardiol., May 5, 2004; 43(9): 1646 - 1653. [Abstract] [Full Text] [PDF]
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V. H. Chu, C. H. Cabell, D. K. Benjamin Jr, E. F. Kuniholm, V. G. Fowler Jr, J. Engemann, D. J. Sexton, G. R. Corey, and A. Wang Early Predictors of In-Hospital Death in Infective Endocarditis Circulation, April 13, 2004; 109(14): 1745 - 1749. [Abstract] [Full Text] [PDF]
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H. F.J Mannaerts, J. A van der Heide, O. Kamp, M. G Stoel, J. Twisk, and C. A Visser Early identification of left ventricular remodelling after myocardial infarction, assessed by transthoracic 3D echocardiography Eur. Heart J., April 2, 2004; 25(8): 680 - 687. [Abstract] [Full Text] [PDF]
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F. A. Tibayan, F. Rodriguez, F. Langer, M. K. Zasio, L. Bailey, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Does septal-lateral annular cinching work for chronic ischemic mitral regurgitation? J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 654 - 663. [Abstract] [Full Text] [PDF]
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A. M. Pereira, S. W. van Thiel, J. R. Lindner, F. Roelfsema, E. E. van der Wall, H. Morreau, J. W. A. Smit, J. A. Romijn, and J. J. Bax Increased Prevalence of Regurgitant Valvular Heart Disease in Acromegaly J. Clin. Endocrinol. Metab., January 1, 2004; 89(1): 71 - 75. [Abstract] [Full Text] [PDF]
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H. I. Karvounis, I. G. Nouskas, T. M. Farmakis, K. M. Vrogistinos, C. E. Papadopoulos, T. A. Zaglavara, G. E. Parharidis, and G. E. Louridas Evaluation of a Doppler-Derived Index Combining Systolic and Diastolic Left Ventricular Function in Acute Myocardial Infarction Angiology, January 1, 2004; 55(1): 21 - 28. [Abstract] [PDF]
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G. Tarantini, P. Buja, R. Scognamiglio, R. Razzolini, G. Gerosa, G. Isabella, A. Ramondo, and S. Iliceto Aortic valve replacement in severe aortic stenosis with left ventricular dysfunction: determinants of cardiac mortality and ventricular function recovery Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 879 - 885. [Abstract] [Full Text] [PDF]
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W. A. Zoghbi, M. Enriquez-Sarano, E. Foster, P. A. Grayburn, C. D. Kraft, R. A. Levine, P. Nihoyannopoulos, C. M. Otto, M. A. Quinones, H. Rakowski, et al. American Society of Echocardiography: recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography : A report from the American Society of Echocardiography's Nomenclature and Standards Committee and The Task Force on Valvular Regurgitation, developed in conjunction with the American College of Cardiology Echocardiography Committee, The Cardiac Imaging Committee, Council on Clinical Cardiology, The American Heart Association, and the European Society of Cardiology Working Group on Echocardiography, represented by: Eur J Echocardiogr, December 1, 2003; 4(4): 237 - 261. [Full Text] [PDF]
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A Ionescu, A G Fraser, and E G Butchart Prevalence and clinical significance of incidental paraprosthetic valvar regurgitation: a prospective study using transoesophageal echocardiography Heart, November 1, 2003; 89(11): 1316 - 1321. [Abstract] [Full Text] [PDF]
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D. Paparella, L. L. Mickleborough, S. Carson, and J. Ivanov Mild to moderate mitral regurgitation in patients undergoing coronary bypass grafting: effects on operative mortality and long-term significance Ann. Thorac. Surg., October 1, 2003; 76(4): 1094 - 1100. [Abstract] [Full Text] [PDF]
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R. Lombardi, S. Betocchi, M. A. Losi, C. G. Tocchetti, M. Aversa, M. Miranda, G. D'Alessandro, A. Cacace;, Q. Ciampi, and M. Chiariello Myocardial Collagen Turnover in Hypertrophic Cardiomyopathy Circulation, September 23, 2003; 108(12): 1455 - 1460. [Abstract] [Full Text] [PDF]
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B. Absil, F. Dagenais, P. Mathieu, J. Metras, J. Perron, R. Baillot, R. Bauset, and D. Doyle Does moderate mitral regurgitation impact early or mid-term clinical outcome in patients undergoing isolated aortic valve replacement for aortic stenosis? Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 217 - 222. [Abstract] [Full Text] [PDF]
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A. D'Aloia, P. Faggiano, G. Aurigemma, L. Bontempi, G. Ruggeri, M. Metra, S. Nodari, and L. Dei Cas Serum levels of carbohydrate antigen 125 in patients with chronic heart failure: Relation to clinical severity, hemodynamic and Doppler echocardiographic abnormalities, and short-term prognosis J. Am. Coll. Cardiol., May 21, 2003; 41(10): 1805 - 1811. [Abstract] [Full Text] [PDF]
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S. Bevilacqua, A. G. Cerillo, J. Gianetti, U. Paradossi, M. Mariani, S. Matteucci, E. Kallushi, and M. Glauber Mitral valve repair for degenerative disease: is pericardial posterior annuloplasty a durable option? Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 552 - 559. [Abstract] [Full Text] [PDF]
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T. Kumanohoso, Y. Otsuji, S. Yoshifuku, K. Matsukida, C. Koriyama, A. Kisanuki, S. Minagoe, R. A. Levine, and C. Tei Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction: Quantitative analysis of left ventricular and mitral valve geometry in 103 patients with prior myocardial infarction J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 135 - 143. [Abstract] [Full Text] [PDF]
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A. M. Gillinov and D. M. Cosgrove III Mitral Valve Repair Card. Surg. Adult, January 1, 2003; 2(2003): 933 - 950. [Full Text]
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J. D Thomas DOPPLER ECHOCARDIOGRAPHIC ASSESSMENT OF VALVAR REGURGITATION Heart, December 1, 2002; 88(6): 651 - 657. [Full Text] [PDF]
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A. Ghai, C. Silversides, L. Harris, G. D. Webb, S. C. Siu, and J. Therrien Left ventricular dysfunction is a risk factor for sudden cardiac death in adults late after repair of tetralogy of fallot J. Am. Coll. Cardiol., November 6, 2002; 40(9): 1675 - 1680. [Abstract] [Full Text] [PDF]
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