[Echocardiographic quantification of mitral regurgitation. Comparative study with transthoracic and transesophageal Doppler color echocardiography]

The quantification of mitral regurgitation by means of colour coded Doppler echocardiography still is a controversial issue. A prospective study on 86 consecutive patients with mitral regurgitation diagnosis was carried out by means of conventional transthoracic colour coded Doppler echocardiography in order to make a comparative study with results obtained by means of transoesophageal colour coded Doppler echocardiography. A systematic measurement of the following parameters was carried out in each patient: Colour coded area or mitral regurgitation jet, auricular depth of mitral regurgitation jet, severity degree of mitral regurgitation, left auricular area, mitral regurgitation ratio and transthoracic crossection plan of largest regurgitation area. Both echocardiographic techniques had the first three parameters in common. The mitral regurgitation area by transthoracic echocardiography was 370 +/- 41 mm2 and by transoesophagial technique 558 +/- 43 mm2 (p less than or equal to 0.001 - r = 0.71). The depth of mitral regurgitation by transthoracic path was 31 +/- 2.7 mm and by transoesophageal path 37 +/- 25 mm (p less than or equal to 0.01 - r = 0.74). The existing correlation between the mitral regurgitation area obtained by both techniques improved (r = 0.84) when a four camera apical transthoracic plan was used and worsened (r = 0.45) when the longitudinal parasternal path was used. We came to the conclusion that the valorization of mitral regurgitation made by both techniques is not accurately comparable, existing undervaluation in transthoracic echocardiography. The discrepancies between the two techniques are more patent and statistically more significant when longitudinal parasternal plan is used for transthoracic quantification of severity degree of mitral regurgitation.(ABSTRACT TRUNCATED AT 400 WORDS)