Non-invasive recording of mitral valve flow velocity patterns using pulsed Doppler echocardiography. Application to diagnosis and evaluation of mitral valve disease.

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Abstract
A new technique using pulsed Doppler echocardiography for non-invasive recording of blood flow velocity patterns at the site of the mitral annulus is described. In a control group of 30 subjects in whom an organic or functional lesion of the mitral valve was ruled out, the normal flow velocity pattern was found to be similar to that obtained either experimentally using an implanted electromagnetic cuff flowmeter or clinically by using the transseptal catheterisation continuous wave Doppler technique. In 31 patients with confirmed mitral valve disease, the mitral valve flow velocity patterns were correlated with the clinical and hemodynamic data and in 10 cases the patterns were compared with the flow velocity curves recorded in the same patients using the Doppler ultrasonic transseptal catheterization of the mitral valve. In most cases, characteristic anomalies of these patterns were noted and could be related to the type of the lesion, stenosis, regurgitation or a combination of these. Specific patterns of mitral valve flow velocity profiles were shown to correlate satisfactorily with the degree of the lesion, with some reservations for mitral regurgitation. The pulsed Doppler technique is a new and promising non-invasive method for establishing the diagnosis of mitral stenosis and/or regurgitation, and to some extent, grading the severity of mitral valve disease using pattern recognition. It provides an original approach to the understanding of mitral hemodynamic disturbances on a beat-to-beat basis.