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[The left ventricle in mitral valve insufficiency: echocardiographic evaluation and hemodynamic correlations]
Insights
Echocardiography underestimates left ventricular volumes in mitral regurgitation (MR) patients. However, echocardiography-calculated ejection fraction is a reliable measure for assessing MR severity.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Physiology
Context:
- Mitral regurgitation (MR) is a significant valvular heart disease.
- Accurate assessment of left ventricular (LV) dimensions and function is crucial for managing MR.
- Echocardiography is a primary non-invasive imaging modality for cardiac assessment.
Purpose:
- To compare echocardiographic measurements of LV dimensions and volumes with standard angiographic calculations in patients with MR.
- To evaluate the reliability of echocardiography in assessing LV volumes and ejection fraction in the context of MR.
Summary:
- This study assessed 69 patients with mitral regurgitation (MR) undergoing echocardiography and cardiac catheterization.
- While echocardiography underestimated LV volumes, significant correlations were found for end-diastolic, end-systolic, and stroke volumes.
- Echocardiography-calculated ejection fraction demonstrated high reliability across all MR severity groups (mild, moderate, severe).
Impact:
- M-mode echocardiography for LV volumes is generally unsatisfactory in MR patients.
- Echocardiography-derived ejection fraction provides a reliable metric for evaluating cardiac function in MR.
- Findings support the use of echocardiography for functional assessment in MR, guiding clinical management.
Abstract:
We have assessed the value of echocardiographic measurements of left ventricular dimensions, as compared to the standard angiographic calculations, in patients (pts) with mitral regurgitation (MR). Of 126 such pts who had undergone echocardiography and cardiac catheterization, 57 were excluded because of associated congenital cardiac malformations, additional significant valvular disease(s) and technically unsatisfactory echocardiographic study. Of the remaining 69 pts, 24 had rheumatic MR (14 with associated mild stenosis); ischemic heart disease was the cause of MR in 1 pts; myxomatous degeneration was found in 12 and congestive cardiomyopathy in 7. The pts were further subdivided in 3 groups according to the severity of MR. Although in all groups echocardiography consistently underestimated left ventricular volumes, there was a statistically significant correlation for end-diastolic volumes, end-systolic volumes and stoke volumes in all three groups. The best correlation was obtained in the calculation of ejection fraction (r = 0.87; P less than 0.001 in mild MR. r = 0,82; P less than 0,001 in moderate MR. r = 0,81; P less than 0,001 in severe MR). The measurement of left ventricular volumes by M-mode echocardiography is generally unsatisfactory in patients with MR. The echo-calculated ejection fraction however, appears to be reliable.