Abstract 15413: Utility of an Innovative Echocardiographic Parameter for Mitral Regurgitation Severity
Background: Generally, the severity of mitral regurgitation (MR) is evaluated with proximal isovelocity surface area (PISA) or volumetric methods. However, there are some difficulties for the quantification of mitral regurgitation severity. Recently, left ventricular early inflow-outflow index (LVEIO index), which is calculated by dividing the mitral E-wave velocity by the LV outflow velocity time integral has been proposed as a simple method. The aim of this study is to determine the ideal threshold of LVEIO index to diagnose severe MR in the different etiologies.
Methods and Results: We reviewed 76721 transthoracic echocardiography reports at the hospital of Hyogo College of Medicine from 2008 to 2015. MR severities were evaluated according to the guideline of the American society of echocardiography. We excluded the cases with moderate or severe aortic valve regurgitation, any mitral stenosis, prior mitral valve surgery, congenital heart diseases, LV assist device, or any arrhythmias. Also cases with inadequate or missing LV inflow or outflow Doppler recordings were excluded. Finally we evaluated 18692 cases and classified them as 17961 of no, trivial, or mild MR(Grade 0/1), 600 of moderate MR(Grade 2), 82 of moderate to severe MR(Grade 3) and 49 of severe MR (Grade 4) . The average LVEIO index of Grade 0/1, Grade 2, Grade 3 and Grade 4 were 3.4 ± 2.7, 5.5 ± 5.0, 6.7 ± 6.2 and 9.1 ± 5.6, respectively. The optimal threshold of LVEIO was 5.4 to distinguish moderate to severe or severe MR from non-severe MR (sensitivity 84%, specificity 91%). There were no differences in the significance of LVEIO index between the cases with reduced LV ejection fraction (< 50%) and preserved LV ejection fraction (≥ 50%), which area under the curves were 0.94 and 0.92, respectively. Secondary MR had greater average of LVEIO than primary MR, suggesting the need of the specific assessment for MR severity by LVEIO in the different etiologies.
Conclusion: LVEIO is a simple useful method to diagnose severe MR by using adequate thresholds according to the etiology of MR regardless of LVEF.
Author Disclosures: A. Matsumoto: None. A. Goda: None. M. Sugahara: None. K. Masai: None. Y. Soyama: None. T. Masuyama: None. T. Mano: None.
- © 2016 by American Heart Association, Inc.