Analysis of different methods of assessing the stenotic mitral valve area with emphasis on the pressure gradient...

There are 2 different theoretical models that analyze factors influencing the transmitral pressure gradient half-time (T1/2), defined as the time needed for the pressure gradient to reach half its initial value. In this report the models and the assumptions inherent in them were summarized. One model includes left heart chamber compliance, the other does not. Although the models at a superficial glance seem to be contradictory, the conclusions drawn from them are similar: i.e., T1/2 is influenced not only by valve area, but also by initial maximal pressure gradient and by flow. Different clinical situations in which the T1/2 method for valve area estimation has been shown not to work are analyzed in the 2 models. It is concluded that these models have contributed to our understanding of the T1/2 concept and when it should not be used. We also advocate use of the continuity equation in these situations, since no assumptions then need be made.