Detection and estimation of the degree of mitral regurgitation by range-gated pulsed doppler echocardiography.

Abstract

Sensitivity and specificity of detection of mitral regurgitation was assessed by range-gated Doppler echocardiography. The degree of mitral regurgitation was also estimated by the depth and width of the regurgitant jet detected with Doppler and compared with that assessed by left ventriculography. Of 47 patients with an adequate Doppler study, 24 had no mitral regurgitation by ventriculography. All but one were also negative for mitral regurgitation by Doppler, for a specificity of 96%. Of 23 cases with mitral regurgitation documented by ventriculography, Doppler detected mitral regurgitation in 21, for a sensitivity of 92%. Two cases with mitral regurgitation undiagnosed by Doppler had mild mitral regurgitation due to papillary muscle dysfunction. All cases with rheumatic mitral regurgitation were detected. The degree of mitral regurgitation estimated with Doppler had a high correlation with that determined by ventriculography (r = 0.88, p less than 0.01).

A new method for noninvasive quantification of valvular regurgitation based on conservation of momentum. In vitro validation.

“…The correspondence of this region with the fully developed turbulent jet was shown by plotting peak u0/peak urn as a function of axial distance (Figure 1, bottom panel) In both pulsatile flow (circular orifices) and steady flow (noncircular orifice), the behavior of centerline velocity as a function of distance agreed with that described for free jets (Figures 6,1). Peak centerline velocity remained relatively constant near the ori- fice (laminar core) and then decayed entrainment and momentum conservat As shown in Figure 7 (lower panels calculated to actual flow rate centered (i.e., Equation 2 reflecting the different geometry. Although the laminar core, indicated by the region in which values of uJum lie along the line of unity, was shorter for the smaller circular orifice than for the larger orifices ( Figure 7, upper panels), the region x>35 mm was used for simplicity because it ensured fully developed turbulence for all jets studied.…”

“…The behavior of centerline velocity urn as a function of distance into the jet was studied both in pulsatile flow (circular orifices) and in steady flow (noncircular orifice) to show the region of applicability of the derived equations, which hold true for the fully developed turbulent jet (Figure 1). The region where Equation 2 applied was shown by plotting the ratio of calculated to actual peak flow rate versus axial distance. The correspondence of this region with the fully developed turbulent jet was shown by plotting peak u0/peak urn as a function of axial distance (Figure 1, bottom panel) In both pulsatile flow (circular orifices) and steady flow (noncircular orifice), the behavior of centerline velocity as a function of distance agreed with that described for free jets (Figures 6,1).…”

Improvement in left ventricular dysfunction after surgical correction of mitral regurgitation

“…Of the 53 patients, 11 who had systolic diameter ≥51 mm (mean = 57±4mm, ranging from 51 to 65mm) were selected for the study. Mitral regurgitation was considered severe based on the clinical picture and on Doppler echocardiography evaluation 8,9 . Exclusion criteria included acute mitral regurgitation or mitral regurgitation with symptoms lasting less than 6 months, previous cardiac surgery, moderate or severe aortic valvar disease, congenital cardiopathy, coronary artery disease, or dilated cardiomyopathy.…”

“…The semiquantitative assessment of mitral regurgitation was determined on a scale of 1+ to 4+ degrees 8,9 . Echocardiographic measures performed in the unidimensional mode were guided by the bidimensional mode.…”

Utility of Physical Examination and Noninvasive Tests in the Diagnosis of Degeneration of Porcine Bioprosthetic Valves in the Mitral Position

“…Valve thickness was measured from the M-mode tracing during systole for the mitral valves [5]. Mitral valve systolic flutter was con sidered indicative of valve regurgitation [6]. The presence of flail valve motion was determined from both M-mode and 2-D images.…”