INFLUENCE OF THE MECHANISM OF REGURGITATION ON THE QUANTIFICATION OF MITRAL REGURGITATION BY THE PROXIMAL FLOW CONVERGENCE METHOD AND THE JET AREA METHOD

In 84 patients mitral regurgitation was quantified by angiography. The mechanism of regurgitation was determined by echocardiography (organi c, n=54, functional, n=30). The radii of the proximal isovelocity surf ace areas in the flow convergence region for 28 and 41 cm.s(-1) blood flow velocity and the area and length of the regurgitant jet were meas ured using colour how Doppler imaging. The radii of the proximal isove locity surface areas correlated more closely with the angiographic gra de than the jet parameters irrespective of the mechanism of regurgitat ion. In mon than 90% of the patients, grades I-II mitral regurgitation were correctly differentiated from grades III-IV by means of the radi i of the proximal isovelocity surface areas. Using the jet parameters, the differentiation was correct in 50-90% of the patients depending o n the mechanism of regurgitation. The jet area method particularly fai led to identify grades III-IV organic mitral regurgitation due to a hi gh prevalence of eccentric jets in these patients. It is concluded tha t the proximal flow convergence method was suitable for the quantifica tion of mitral regurgitation irrespective of the mechanism of mitral r egurgitation. On the other hand, the value of the jet area method depe nded largely on the regurgitation mechanism.