Regurgitant jet area by Doppler color flow mapping: quantitative assessment of mitral regurgitation severity in dogs

Muzzi, Ruthnéa Aparecida Lázaro; Araújo, Roberto Baracat de; Muzzi, Leonardo Augusto Lopes; Pena, J.L.B.; Silva, Euler Fraga

doi:10.1016/s1760-2734(06)70050-9

Cited by 59 publications

(55 citation statements)

References 15 publications

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“…On the basis of these examinations, dogs with MR were numbered and arranged in order of MR severity (Table 1). 18 Measurements were carried out for a period of 72 consecutive hours (3 days) and the characteristics of circadian LAP variation were evaluated by the following 4 procedures:…”

Section: Diurnal Lap Variations Protocolmentioning

confidence: 99%

Daily Rhythms of Left Atrial Pressure in Beagle Dogs with Mitral Valve Regurgitation

Ishikawa¹,

Tanaka²,

Suzuki³

et al. 2009

Veterinary Internal Medicne

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Background: Mitral valve regurgitation (MR) causes increased left atrial pressure (LAP) and is associated with occurrence of clinical signs. It will be useful to understand diurnal variations of LAP for the management of MR.Hypothesis: Circulatory parameters and diurnal rhythm are linked to clinical signs in cardiac diseases. LAP also exhibits a diurnal rhythm in dogs with MR.Animals: Five healthy Beagle dogs weighing 9.8-12.8 kg (3 males and 2 females; aged 2 years) were used. Methods: A radiotelemetry system for continuous measurement of LAP was used in this study. Rupture of the chordae tendineae was experimentally induced via left atriotomy, and a transmitter catheter was inserted into the left atrium. The body of the transmitter was implanted SC. After clinical condition was stabilized, the severity of MR was evaluated by echocardiography, and LAP was recorded for 72 consecutive hours for the analysis of diurnal variation.Results: Abrupt increases in LAP, which averaged 16.7 mmHg, were observed at feeding periods. In contrast, strong diurnal LAP variations were found, with a significant but slight increase in daytime LAP compared with nighttime LAP.Conclusions and Clinical Importance: Diurnal LAP is characterized by a slight but significant nocturnal decrease and abrupt increases in response to excitation. The latter seemed to be more important considering the relationship with clinical manifestations. The clinical relevance of exercise restriction in the management of MR was acknowledged.

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Section: Diurnal Lap Variations Protocolmentioning

confidence: 99%

Daily Rhythms of Left Atrial Pressure in Beagle Dogs with Mitral Valve Regurgitation

Ishikawa¹,

Tanaka²,

Suzuki³

et al. 2009

Veterinary Internal Medicne

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“…Calculation of the ARJ/LAA ratio using CFD mapping is commonly used as a noninvasive method for assessing the severity of MR in veterinary medicine 2, 12. The major advantages of this method are its rapidity and the ease of data acquisition 1.…”

Section: Discussionmentioning

confidence: 99%

“…However, jet area evaluation is limited by a variety of hemodynamic (eg, systemic hypertension, ventricular‐atrial pressure gradient reduction, loading conditions, left atrial compliance) and technical factors (eg, gain setting, angle between the jet and the ultrasound beam, orientation of the jet) 1, 11, 13, 22. Doppler color flow mapping may also markedly underestimate the severity of MR in eccentric jets: a flow jet directed against the atrial wall appears smaller than a central jet of the same regurgitant volume (Coanda effect), which could lead to an underestimation of the severity of MR 1, 6, 11, 12, 13, 18, 22, 31, 37…”

Section: Discussionmentioning

confidence: 99%

“…The records were selected according to the following inclusion criteria: diagnosis of MVD; complete medical records referring to the first visit; thoracic radiography in presence of clinical signs2, 11; electrocardiographic examination2, 11; complete data for echocardiographic and Doppler examinations as recommended by the authors to achieve grading of MR severity (ARJ/LAA ratio), mitral inflow pattern analyzed by pulsed wave (PW), signal intensity (jet density) of the continuous wave (CW), and envelope of the MR jet assessment of MR severity achieved by quantitative PISA and semiquantitative methods 1, 8, 11, 21, 22, 24, 26. We first graded the disease by means of quantitative methods and semiquantitative methods (different from VCW) and then observed how VCW values were distributed among different grade of MR severity (average based on ≥ 3 measurements for each parameter) 1, 2, 3, 10, 11, 12, 13. Exclusion criteria included presence of congenital heart disease; presence of atrial fibrillation, any other arrhythmias, or both that severely altered the beat to beat time interval11; VCW, PISA, or both not clearly visualized11; presence on CFD imaging of more than 1 mitral regurgitant jet evidenced through accurate recording at the time of the examination 8…”

Section: Methodsmentioning

confidence: 99%

“…MR severity was graduated on the basis of the area of the regurgitant jet projecting into the left atrium, the jet density of the CW Doppler signal, the mitral inflow pattern analyzed by PW Doppler, and EROA dimensions 1, 7, 8, 10, 11, 12, 21, 22, 24, 31. The grade of MR was classified as mild (L), mild‐to‐moderate (LM), moderate (M), moderate‐to‐severe (MS), or severe (S) 6, 10, 14, 15, 16, 21, 32…”

Section: Methodsmentioning

confidence: 99%

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Assessment of Mitral Regurgitation Severity by Doppler Color Flow Mapping of the Vena Contracta in Dogs

Marcello¹,

Terzo

Locatelli

et al. 2014

Veterinary Internal Medicne

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BackgroundQuantitative and semiquantitative methods have been proposed for the assessment of MR severity, and though all are associated with limitations. Measurement of vena contracta width (VCW) has been used in clinical practice.ObjectiveTo measure the VCW in dogs with different levels of MR severity.AnimalsTwo hundred and seventy‐nine dogs were classified according to 5 levels of MR severity.MethodsThis was a retrospective study. EROA and regurgitant volume calculated by the PISA method, were measured and indexed to BSA. Descriptive statistics were calculated for VCW and VCW index for all categories of MR severity. Spearman's rank correlation coefficients (ρs) were calculated to compare the results of the different methods (VCW and VCW index vs RV PISA, RV PISA index, EROA, EROA index), and between VCW and VCW index versus MR severity.ResultsAll Spearman's rank correlation coefficients were significant (P < .001). The median values of VCW resulted of 2.9 mm (IQR 3.4–2.5) and of 4.6 mm (IQR 5.4–4.1) in the groups previously classified as mild‐to‐moderate and moderate‐to‐severe, respectively. The median values of VCW index resulted of 4.4 mm/m2 (IQR = 5.5–4.2) in mild‐to‐moderate MR and of 10.8 mm/m2 (IQR = 12.8–9.4) in moderate‐to‐severe MR.Conclusion and Clinical ImportanceThis is not a validation study against any previously validated invasive gold standard, the VCW method has proved easy to employ and it might be an additional tool in quantifying disease severity that supports, rather than replace, data coming from other techniques in daily clinical practice and research.

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Abnormal Heart Sounds

2019

Common Clinical Presentations in Dogs and Cats

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Regurgitant jet area by Doppler color flow mapping: quantitative assessment of mitral regurgitation severity in dogs

Cited by 59 publications

References 15 publications

Daily Rhythms of Left Atrial Pressure in Beagle Dogs with Mitral Valve Regurgitation

Daily Rhythms of Left Atrial Pressure in Beagle Dogs with Mitral Valve Regurgitation

Assessment of Mitral Regurgitation Severity by Doppler Color Flow Mapping of the Vena Contracta in Dogs

Abnormal Heart Sounds

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