To determine prospectively the prevalence of mitral, aortic, tricuspid, and pulmonary regurgitation in normal persons, 211 consecutive, apparently healthy volunteers were examined with a color Doppler flow imaging system. The subjects were divided into five age groups (group 1, 6-9 years old; group 2, [10][11][12][13][14][15][16][17][18][19]

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To assess the prevalence of valvular regurgitation in the aged, we studied 176 apparently healthy volunteers with no history or physical evidence of cardiac abnormality. Their ages ranged from 40 to 90 (66 ± 14, mean ± SD) years. We examined these subjects by pulsed Doppler echocardiography combined with two-dimensional echocardiography to determine the prevalence of valvular regurgitation. Regurgitation began to appear in subjects in their fifties, increasing in prevalence with advancing age (r = .81, p < .001), and was documented in all over age 80. Similarly, regurgitation involving more than one valve appeared in those 60 years and older, and was very common (89%) in subjects in their eighties. With each type of valvular regurgitation, the prevalence of each type of regurgitation increased with aging, but this tendency was most prominent for aortic regurgitation. We conclude that (1) single or multivalvular regurgitation as detected by pulsed Doppler echocardiography is very common in the aged and may be considered a normal finding in the absence of other evidence of heart disease, and (2) the high prevalence of regurgitation in the aged must be taken into account when Doppler examinations are being performed. Circulation 76, No. 2, 262-265, 1987. PULSED DOPPLER echocardiography is a noninvasive technique that has proved useful in the detection of valvular regurgitation. The high degree of specificity and sensitivity of this technique has been reported. 1 11 The atrioventricular valves are known to become thicker and more opaque with advancing age,12 15 and similar changes may occur in the semilunar valves. The grade of these changes is in part genetically determined and in part age related. 12 16 Therefore, multivalvular regurgitation of little or no clinical significance can be expected to occur in older subjects. The purpose of this study was to investigate the prevalence of valvular regurgitation in the aged by pulsed Doppler echocardiography. Subjects and methodsApparently healthy volunteers without cardiac symptoms were studied. All were outpatients or inpatients of the Depart- ment of Ophthalmology of Kobe General Hospital who were undergoing routine vision testing or were being considered for cataract surgery. None had received a prior diagnosis of cardiac disease or had valvular regurgitation of a known cause such as rheumatic fever, myocardial infarction, hypertension, or mitral valve prolapse. Before the pulsed Doppler echocardiographic study, a physical examination was performed and a 12-lead electrocardiogram as well as a two-dimensional echocardiogram were recorded to exclude known causes of valvular regurgitation. Patients were excluded if they had a significant murmur, atrial fibrillation, left ventricular hypertrophy, evidence of previous myocardial infarction, asynergy of the left ventricle, mitral annular calcification, or a perceptible aortic valve abnormality. Finally, 176 of 227 apparently healthy volunteers were studied by pulsed Doppler echocardiography. Their ages range...

BackgroundMyocardial contrast echocardiography and coronary flow velocity pattern with a rapid diastolic deceleration time after percutaneous coronary intervention has been reported to be useful in assessing microvascular damage in patients with acute myocardial infarction.AimTo evaluate myocardial contrast echocardiography with harmonic power Doppler imaging, coronary flow velocity reserve and coronary artery flow pattern in predicting functional recovery by using transthoracic echocardiography.MethodsThirty patients with anterior acute myocardial infarction underwent myocardial contrast echocardiography at rest and during hyperemia and were quantitatively analyzed by the peak color pixel intensity ratio of the risk area to the control area (PIR). Coronary flow pattern was measured using transthoracic echocardiography in the distal portion of left anterior descending artery within 24 hours after recanalization and we assessed deceleration time of diastolic flow velocity. Coronary flow velocity reserve was calculated two weeks after acute myocardial infarction. Left ventricular end-diastolic volumes and ejection fraction by angiography were computed.ResultsPts were divided into 2 groups according to the deceleration time of coronary artery flow pattern (Group A; 20 pts with deceleration time ≧ 600 msec, Group B; 10 pts with deceleration time < 600 msec). In acute phase, there were no significant differences in left ventricular end-diastolic volume and ejection fraction (Left ventricular end-diastolic volume 112 ± 33 vs. 146 ± 38 ml, ejection fraction 50 ± 7 vs. 45 ± 9 %; group A vs. B). However, left ventricular end-diastolic volume in Group B was significantly larger than that in Group A (192 ± 39 vs. 114 ± 30 ml, p < 0.01), and ejection fraction in Group B was significantly lower than that in Group A (39 ± 9 vs. 52 ± 7%, p < 0.01) at 6 months. PIR and coronary flow velocity reserve of Group A were higher than Group B (PIR, at rest: 0.668 ± 0.178 vs. 0.248 ± 0.015, p < 0.0001: during hyperemia 0.725 ± 0.194 vs. 0.295 ± 0.107, p < 0.0001; coronary flow velocity reserve, 2.60 ± 0.80 vs. 1.31 ± 0.29, p = 0.0002, respectively).ConclusionThe preserved microvasculature detecting by myocardial contrast echocardiography and coronary flow velocity reserve is related to functional recovery after acute myocardial infarction.