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Peak mitral inflow velocity predicts mitral regurgitation severity
L Thomas1, E Foster, N B Schiller
1Division of Cardiology, University of California San Francisco, 94142-0214, USA.
Journal of the American College of Cardiology
|January 13, 1998
Summary
Peak E wave velocity is a simple echocardiographic measurement that can effectively screen for severe mitral regurgitation (MR). This method aids in assessing MR severity when precise quantification is challenging.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Physiology
Background:
- Mitral regurgitation (MR) is common, but accurate quantification is difficult.
- Increased regurgitant volume in MR affects left atrial-left ventricular gradients.
- Peak mitral inflow (E wave) velocity is hypothesized to correlate with MR severity.
Purpose of the Study:
- To develop an easily measured screening variable for hemodynamically significant MR.
- To assess the relationship between peak E wave velocity and MR severity.
- To establish a simple method for MR quantification in clinical practice.
Main Methods:
- Retrospective analysis of 102 patients with varying MR grades.
- Measurement of peak E wave velocity, E/A ratio, and other Doppler parameters.
- Reference standard: expert echocardiographic evaluation and quantitation of regurgitant fraction.
Main Results:
- Peak E wave velocity increased significantly with MR severity (p < 0.0001).
- E wave velocity correlated with regurgitant fraction (r = 0.52, p < 0.001).
- E wave velocity >1.2 m/s showed 86% sensitivity and 86% specificity for severe MR.
Conclusions:
- Peak E wave velocity is a practical and widely applicable screening tool for MR severity.
- This simple measurement aids in evaluating patients with mitral regurgitation.
- An A wave dominant pattern effectively excluded severe MR.