Echo-Doppler quantitative assessment of non-ischaemic mitral regurgitation

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Abstract
The reliability of non-invasive quantification of mitral regurgitation (MR) was msessed in 76 patients with angiographically demonstrated MR by comparing the results of different echo-Doppler (ED) indices with angiographic grade and MR fraction (MRF). Echo-Doppler studies were performed within 72h of right and left heart catheterizations in all patients. The following results were obtained: Transthoracic maximal relative jet area (RJA) k dkappointing and differentiates only grade 1 from grade 4MR. RIA correlates better with haemodynamic data when obtained by transoesophageal echo: r=0·78 versus r=0·62, P50% and/or a jet width >6mm measured at the origin of the jet are strong indicators of severe MR. The ratio of mitral velocity time integral (VTI) to aortic VTI correlates with MRF: r=0·77, P1=3 identifies RF >40% with a sensitivity of 80% and a specificity of 87%. A total inversion of the systolic wave of pulmonary venous flow is specific for grade 4 MR. The Doppler-derived MRF, correlates well with haemodynamic RF (r=0.92, P =0·001, SEE: 7=5%).

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