Iraqi Journal of Medical Sciences








Vol. 12 Issue 3 July - September / 2014
Published on website | Date : 2016-03-24 10:00:45

ASSESSMENT OF MITRAL REGURGITATION SEVERITY BY DIFFERENT ECHOCARDIOGRAPHIC METHODS IN COMPARISON WITH LEFT VENTRICLE ANGIOGRAPHY

Rafid B. Altaweel, Muthanna H. Al-Quraishi


Abstract

Background:Proximal isovelocity surface area method and mitral regurgitatant jet estimation (with its ratio to left atrium) are reliable methods for estimation of mitral regurgitation severity aiding in management strategy, precluding the use of other invasive procedures for assessment (e.g. left ventricular angiography).
Objective:To study the usefulness of proximal isovelocity surface area and regurgitant jet size (with its ratio to left atrium) to determine the severity of mitral regurgitation in comparison with left ventricle angiography.
Methods:Forty patients with mitral regurgitation planned to do left ventriculography to assess mitral regurgitation severity were studied. Estimation of mitral regurgitatant jet (and its ratio to left atrium) by color tracing of maximal jet area and estimation of effective regurgitant orifice, regurgitant volume and regurgitant fraction by proximal isovelocity surface area method were reported within 24-48 hours after angiography.
Results:The effective regurgitant orifice, regurgitant volume and regurgitant fraction in correlation with angiographic grades were 46.67±27.mm2 (P < 0.0001); 55.3 5±27.67 ml (P < 0.0001) and 57.41±20.63 % (P < 0.0001) respectively. The thresholds for severe mitral regurgitation (grade 4) were 60 mL, 52%, and 42.5 mm2 for regurgitant volume, regurgitant fraction, and effective regurgitant orifice, respectively. Significant correlation (P = 0.021) of mean mitral regurgitant/left atrium ratio with the corresponding angiographic grade in central mitral regurgitation, while no significant correlation (P = 0.799) was found in eccentric mitral regurgitation.
Conclusion:Proximal convergence method and estimation of mitral regurgitant size (ratio to left atrium) by color tracing of maximal jet area (in central jet) allows accurate estimation of the mitral regurgitation severity.
Keywords:Proximal isovelocity surface area method, effective regurgitant orifice, mitral regurgitant volume


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