AUTOMATED ASSESSMENT OF MITRAL REGURGITANT VOLUME AND REGURGITANT FRACTION BY A NEWLY DEVELOPED DIGITAL COLOR DOPPLER VELOCITY PROFILE INTEGRATION METHOD

Recent development of the automated cardiac flow measurement (ACFM) me thod has provided automated measurement of stroke volume and cardiac o utput by spatial and temporal integration of digital Doppler velocity profile data. The purpose of this study was to evaluate the clinical u sefulness of the ACFM method using digital color Doppler velocity prof ile integration in the assessment of mitral regurgitant volume and reg urgitant fraction from measurements of both aortic outflow and mitral inflow volumes. We calculated both aortic outflow and mitral inflow vo lumes from the apical approach with the ACFM and pulsed Doppler (PD) m ethods in 20 patients with isolated mitral regurgitation. Mitral regur gitant volume and regurgitant fraction were calculated by the followin g equation: mitral regurgitant volume = (mitral inflow volume) - (aort ic outflow volume), % regurgitant fraction = (mitral regurgitant volum e)/(mitral inflow volume) x 100. Mitral regurgitant volume and regurgi tant fraction were compared with that determined by the PD method. Mit ral regurgitant volume measurement by the ACFM method showed a good co rrelation with that measured by the PD method (r = 0.90, y = 0.77x + 1 1.6, SEE = 9.0 ml); the mean differences between PD and ACFM measureme nts was -1.7 +/- 12.5 ml. Regurgitant fraction estimated by the ACFM m ethod correlated well with that of the PD method (r = 0.92, y = 0.98x + 2.1, SEE = 8.8%). The mean difference for the measurement of regurgi tant fraction between the PD and ACFM methods was 0.8 +/- 6.6%. Total time required for mitral regurgitant volume calculation in 1 cardiac c ycle by the ACFM method was significantly shorter than that of the PD method (126 +/- 15 seconds vs 228 +/- 36 seconds, p < 0.01). In conclu sion, the newly developed ACFM method is simple, quick, and accurate i n the automated assessment of mitral regurgitant volume and regurgitan t Fraction. (C) 1997 by Excerpta Medica, Inc.