Abstract 14543: The Mitral Regurgitation Severity Index: Revisiting a Spectral Doppler based Echocardiographic Tool for the Assessment of Mitral Regurgitation Severity
Introduction: Accurate assessment of mitral regurgitation (MR) severity is vital in making decision about corrective surgery. However, existing metrics are limited in terms of high inter-observer variability.We evaluated a Doppler-based, semi-quantitative novel index (Mitral regurgitation severity index, MRSI) of MR severity.
Methods: The MR Severity Index (MRSI) was calculated as the ratio of the time velocity integral of mitral inflow (continuous wave (CW) Doppler-VTI MV) to the time velocity integral of flow in the left ventricle outflow tract (pulsed wave (PW) Doppler- VTI LVOT). Level II and expert Level III readers independently assessed MR severity in 21 patients with severe, 49 patients with mild-moderate MR and 40 healthy controls and validated the results in cohort of patients with 23 severe and with 32 non-severe MR.
Results: In the derivation cohort, MRSI differed significantly among patients with severe and mild-moderate MR with sensitivity of 89% and specificity of 91%. In the validation cohort, MRSI had excellent inter- and intra-observer reproducibility (fig 1). A MRSI cut-off of ≥1.8 had 100% sensitivity and NPV for severe MR. A significant improvement in C-statistics (88% vs 69%, p=0.02) (fig 2) was found with MRSI over conventional criteria for severe MR applied by a Level II reader. MRSI resulted in 36% net upward reclassification among patients with severe MR per Level III reader
Conclusions: The MRSI appears to be a simple, quantitative, practical, robust, color-independent metric to differentiate severe MR from non-severe MR.
Author Disclosures: M. Shokr: None. E. Akintoye: None. A. Briasoulis: None. T. Telila: None. A. Mostafa: None. A. Rashed: None. L. Afonso: None.
- © 2016 by American Heart Association, Inc.