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[The accuracy and applicability of different methods in the Doppler technic for the quantification of mitral
E González Torrecilla1, M A García Fernández, M Barambio
1Departamento de Cardiología, Hospital General Gregorio Marañón, Madrid.
Introduction And Objectives:
We analyse the applicability and accuracy of the various Doppler methods for quantification of mitral stenosis as well as the value of combining measurements.
Patients And Methods:
The study comprised 74 patients with reliable planimetry of mitral orifice. The following Doppler methods were tested: a) pressure half-time; b) color jet width at the mitral valve orifice in the apical long-axis view (short diameter) and its width in the 90 degree rotated view (long diameter), assuming an elliptic mitral orifice; c) proximal isovelocity surface area from the 4-chamber view assuming a hemispheric surface, and d) the continuity equation. The mean value of mitral valve area estimates from all applicable Doppler methods was calculated in each patient.
Results:
The rates of applicability of each method were, respectively: 85, 97, 97 and 53% (p < 0.01). The correlations--r (SEE)--between each method and planimetry were: 0.86 (0.17 cm2), 0.81 (0.19 cm2), 0.74 (0.21 cm2) and 0.83 (0.18 cm2), respectively. The highest correlation was found with the mean value (r = 0.90; SEE = 0.14 cm2), and only this parameter was selected by stepwise multiple regression analysis (r = 0.93; SEE = 0.12 cm2).
Conclusions:
The continuity equation method has the lowest level of obtainable results owing to the high incidence of mitral regurgitation. The mean value of mitral area estimates from all applicable methods in each patient showed the closest correlation with planimetry, thus the performance of these Doppler methods provides improved accuracy in the quantification of mitral stenosis.