Semiquantitative grading of severity of mitral regurgitation by real-time two-dimensional Doppler flow imaging technique

Abstract

An attempt was made to determine whether mitral regurgitation could be detected and its severity evaluated semiquantitatively by newly developed real-time two-dimensional Doppler flow imaging in 109 patients who underwent left ventriculography. In the Doppler flow imaging technique, Doppler signals due to blood flow in the cardiac chambers are processed using a high speed autocorrelation technique, so that the direction, velocity and turbulence of the intracardiac blood flow are displayed in the color-coded mode on the monochrome B-mode echocardiogram in real time. Mitral regurgitant flow was imaged as a jet spurting out from the mitral valve orifice into the left atrial cavity. It was noted that the regurgitant jet in the left atrial cavity had a variety of orientations and dynamic features when studied by the present technique. The sensitivity of the technique in the detection of mitral regurgitation was 86% as compared with that of left ventriculography. Mitral regurgitation in the false negative cases was mostly mild. On the basis of the farthest distance reached by the regurgitant flow signal from the mitral valve orifice, the severity of regurgitation was graded on a four point scale and these results were compared with those of angiography. A significant correlation (r = 0.87) was found between Doppler imaging and angiography in the evaluation of the severity of mitral regurgitation. A similar result was obtained for the evaluation based on the area covered by the regurgitant signals in the left atrial cavity. Thus, noninvasive semiquantitative evaluation by real-time two-dimensional Doppler flow imaging appears to be a promising clinical technique.

Atrial Septal Defect Closure in Geriatric Patients

“…(22,23) Twelve patients had been diagnosed with ASD well before transcatheter closure was attempted but they had refused or hesitated to receive ASD closure. We think that this was partially because they had no recognizable symptom, but mainly because surgical closure was the only treatment at the time when they had been first diagnosed with ASD.…”

Lack of Association Between Perlecan Gene Intron 6 BamHI Polymorphism and Risk of Mitral Valve Prolapse in Taiwan Chinese

“…12) In order to take into account the wide variability in expression of the disease, patients were classified according to the following criteria: (1) a positive diagnosis was made when patients had a redundant valve with a leaflet thickness ≥ 4 mm and a total leaflet displacement ≥ 2 mm; (2) a case was regarded as severe when the patient had a valve thickness > 6 mm or a total leaflet displacement >8 mm, or significant mitral regurgitation (grade ≥ 2 assessed according to the criteria of Miyatake, et al 12) ). Genotyping of the perlecan gene intron 6 BamHI polymorphism: The genomic DNA was prepared from peripheral blood leukocytes using a genomic DNA isolation kit (Blossom, Taipei, Taiwan).…”

Assessment of mitral regurgitation by biplane transesophageal color Doppler flow mapping.

“…Individual values of the maximum jet area from two planes for 11 patients with mild mitral regurgitation by angiography ranged from 1.2 to 3.8 cm2 (mean, 2.28±0.95 cm2). Individual values of the maximum jet area for nine patients with moderate mitral regurgitation by angiography ranged from 4.0 to 6.5 cm2 (mean, 5.62±0.78 cm2), whereas the maximum jet area for 12 patients with severe mitral regurgitation ranged from 5.0 to 13.9 cm2 (mean, 9.28+2.85 cm2). There was a significant difference in the maximum FIGURE A significant correlation (r=0.81) was found between transthoracic color Doppler imaging and left ventriculography in the evaluation of the severity of mitral regurgitation.…”