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[Quantification of mitral regurgitation using Doppler echocardiography]
I Bogdan1, Z Duraković, V Brida
1Iz Zavoda za kardiologiju Klinike za unutrassnje bolesti Medicinskog fakulteta i Klinickog bolnickog centra u Zagrebu.
Insights
Doppler echocardiography accurately quantifies mitral regurgitation severity. This method provides a reliable regurgitation fraction index for grading mitral insufficiency, correlating closely with catheterization results.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Context:
- Mitral regurgitation (MR) is a common valvular heart disease.
- Accurate quantification of MR severity is crucial for patient management.
- Existing methods may have limitations in precise MR assessment.
Purpose:
- To evaluate the accuracy of Doppler echocardiography in quantifying mitral regurgitation.
- To establish a reliable method for estimating the degree of mitral regurgitation.
- To correlate Doppler-derived measurements with established cardiac catheterization techniques.
Summary:
- Doppler echocardiography, using continuous and pulsed waves, was applied to patients with and without mitral regurgitation.
- Regurgitation fraction (RF) and regurgitation fraction index (RFI) were calculated to quantify MR.
- Doppler-derived RFI demonstrated high accuracy in grading mitral insufficiency (mild <45%, severe >45%) and correlated well with angioventriculographic findings.
Impact:
- Provides a non-invasive and accurate method for assessing mitral regurgitation severity.
- Facilitates faster screening and more precise diagnosis of mitral insufficiency.
- Enhances clinical decision-making in the management of patients with heart disease and MR.
Abstract:
Examining 18 patients without regurgitation (control group) and 20 patients with mitral regurgitation the method of Doppler echokardiography, the pulsating and continual wave, was applied. Both groups consisted of patients with heart diseases in whom a heart catheterization was indicated for the evaluation of the actual state. Thus, the competence of the mitral orifice was also evaluated. The aim of the investigation was to quantify or more accurately estimate the degree of mitral regurgitation. The accuracy of the Doppler method was tested by means of the measured cardiac stroke volumes of the right heart side in both groups with the probability higher than 80% but lower than 90% (0.80 less than p 0.23 less than 0.90), and by testing the cardiac stroke volumes of the right heart and the diastolic volumes of the left heart (control group: mitral and pulmonal orifice) with the probability higher than 70% and lower than 80% with the error of 6% of the measured volume. The regurgitation mitral fraction (RF) was presented as the difference between the total forwards volume (TFV) in the mitral orifice and the net forwards volume (NFV) in the pulmonal orifice and calculated in cm3, and as the regurgitation fraction index (RFI) in percentages (RFI = 1--NFV/TFV). It was also expressed as the regurgitation volume index (RVI) whose values were divided into degrees, according to the literature data. Numerical values of the regurgitation fraction and the regurgitation fraction index were classified in the mitral insufficiency degrees from 1 to 4. A fast regurgitation screening was possible due to the regurgitation fraction index, which is lower than the 45% of the diastolic volume in the cases of mild mitral insufficiency, while the values over 45% denote severe mitral insufficiency. The obtained values of the regurgitation fraction and index divided into degrees showed a close correlation with the angioventriculographic degrees obtained by heart catheterization. Cardiac output measured by the Doppler and Fick methods in the group with regurgitation showed a high correlation coefficient (r = 0.85) (0.60 less than p 0.47 less than 0.70).