Non-invasive pulsed Doppler study of mitral stenosis and mitral regurgitation: preliminary study.

Open Access
Publisher Website
Google Scholar
Abstract
The potential value of pulsed Doppler echocardiography in the evaluation of mitral valve lesions was studied before cardiac catheterization in 64 patients with a clinical diagnosis of mitral valve disease. Mitral stenosis was evaluated with the transducer sited at the apex and oriented towards the mitral orifice. Reproducible tracings were obtained when a mitral flow running towards the transducer was recorded when the Doppler sample volume was located close to the mitral annulus and when the flow curves ending with the QRS complex of the ECG were retained for analysis. Of 37 patients in sinus rhythm, the 14 without a mitral valve gradient had a bifid diastolic flow pattern. In patients with mitral valve stenosis, 3 distinct flow patterns corresponding to significantly different mitral valve gradients were defined. In the presence of atrial fibrillation the Doppler analysis could not differentiate patients with mild mitral stenosis from those without a mitral valve gradient. With moderate and severe stenosis, the flow curves were similar to those in sinus rhythm and the method was reliable. Mitral regurgitation was studied by 2 methods. The 1st was previously described for the study of mitral stenosis and was later discarded because of low specificity and sensitivity. Use of a parasternal approach improved the performance and the Doppler results were in good agreement with the left ventriculogram when significant mitral regurgitation was present. These preliminary results suggest that pulsed Doppler echocardiography may be useful as a clinical adjunct for assessing the presence and severity of mitral valve disease.