Severity of mitral regurgitation assessed by echocardiography. Reliability and limitations

To assess whether echocardiography may represent a useful mean to evaluate the degree mitral regurgitation (DR), left ventricular diastolic internal dimension (LVIDd), left atrial dimension (LAD), and velocity of circumferential fiber shortening (Vcf) were compared to DR assessed by left ventriculography in 48 patients with primary (n = 21) and cardiomyopathic (n = 27) valvular incompetence. In patients with good left ventricular contractility, i.e. with Vcf values above 1.02, a significant positive linear correlation was found between LVIDd and DR (LVIDd = 5.38 + 0.45DR; r = 0.72; p less than 0.001). In contrast, in patients with depressed left ventricular function, i.e. with Vcf values below 1.02, LVIDd did not correlate to DR. In either group LAD and Vcf did not correlate to DR. Thus, echocardiography may provide useful semiquantitative information concerning DR only in patients with preserved left ventricular performance.