MEASUREMENT OF MITRAL-VALVE AREA IN MITRAL-STENOSIS - 4 ECHOCARDIOGRAPHIC METHODS COMPARED WITH DIRECT MEASUREMENT OF ANATOMIC ORIFICES

Objectives. This study sought to compare the mitral valve areas of pat ients with rheumatic mitral valve stenoses as determined by means of f our echocardiographic and Doppler methods with those obtained by direc t anatomic measurements.Background. There has been no systemic compari son between Doppler-determined valve areas and the true anatomic orifi ce in a single cohort. Methods. In 30 patients with mitral stenosis, t he mitral valve areas determined by two-dimensional echocardiographic planimetry, pressure half-time, flow convergence region and flow area were compared with the values directly measured on the corresponding e xcised specimen by means of a custom-built sizer. Results. The correla tion coefficient was r = 0.95 (SE 0.06, p < 0.0001) for two-dimensiona l planimetry; r = 0.80 (SE 0.09, p < 0.0001) for pressure half-time; r = 0.87 (SE 0.09, p < 0.0001) for flow convergence region; and r = 0.5 4 (SD 0.1, p < 0.002) for flow area. Two-dimensional echocardiographic planimetry, pressure half-time, flow convergence region and flow area overestimated the actual anatomic orifice by > 0.3 cm(2) in 2, 1, 6 a nd 0 patients, respectively, and underestimated it by > 0.3 cm(2) in 0 , 4, 1 and 8 patients, respectively.Conclusions. Mitral valve areas de termined by two-dimensional planimetry, pressure half-time and proxima l flow convergence region reliably correlated with size of the anatomi c orifice. The flow area method provided a less reliable correlation.