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Vena contracta width as a simple method of assessing mitral valve regurgitation. Comparison with Doppler quantitative
Agata Lesniak-Sobelga1, Maria Olszowska, Piotr Pienazek
1Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University School of Medicine, Kraków, Poland. alesniak@szpitaljp2.krakow.pl
Background And Aim Of The Study:
Quantitative Doppler echocardiography and proximal flow convergence methods facilitate quantification of regurgitant volume (RV), regurgitant fraction (RF) and the measurement of effective regurgitant orifice (ERO) to define mitral regurgitation (MR) severity. Vena contracta width (VCW) has been proposed as a simple, accurate marker of MR, and is instrumental in predicting the angiographic severity of valvular regurgitation. The study aim was to compare VCW with quantitative Doppler methods and angiography for assessing MR.
Methods:
Sixty-four patients with MR (50 males; mean age 54 +/- 8 years; range: 34-84 years) were included. The etiology of MR was coronary artery disease, infective endocarditis, rheumatic disease, dilated cardiomyopathy or mitral valve prolapse. Exclusion criteria included aortic stenosis and/or aortic insufficiency, mitral stenosis, mechanical prostheses and atrial fibrillation. RV and ERO estimated by the proximal isovelocity surface area method (PISA), and RF calculated by Doppler, were compared with VCW measured by color Doppler. The angiographic severity of MR was classified on a four-point scale, in compliance with Sellers' criteria.
Results:
A good correlation was found between VCW and ERO (r2 = 0.70, p <0.001), RV (r2 = 0.73, p <0.001), RF (r2 = 0.71, p <0.001) and angiographic grade (r2 = 0.72, p <0.001).
Conclusion:
VCW measured by color Doppler correlates well with MR severity. In addition, VCW is a simple, reproducible quantitative measurement of MR, and is recommended for use in the non-invasive assessment of the condition.