PULMONARY VENOUS SYSTOLIC FLOW FRACTION IN PATIENTS WITH MITRAL REGURGITATION - TRANSESOPHAGEAL ECHOCARDIOGRAPHIC FINDINGS IN RELATION TO HEMODYNAMIC AND ANGIOGRAPHIC EVALUATION

In patients with mitral regurgitation (MR), pulmonary venous systolic flow fraction (PVSFfr) recorded using pulsed Doppler transoesophageal echocardiography (TEE) was compared with PVSFfr in normal subjects, to angiographic grading and to haemodynamic parameters. PVSfr was calcul ated as the systolic flow velocity integral divided by total inflow in tegral. PVSfr is negative when systolic flow is reversed. Forty patien ts with MR were studied. PVSFfr<0 was 100% sensitive for angiographic severe MR (specificity 83%). In 35 patents heart rate differed by 10 b pm or less between TEE and cath, either at rest or during stress. PVSF fr was correlated with angiographic grade (r=-0.69, P<0.0001), with me an PCW (r=-0.61, P<0.0001), with the v-wave (r=-0.72, P<0.0001), with systolic blood pressure (r=0.48, P<0.005) and with left atrial diamete r (r=-0.52, P<0.005). Stepwise forward multiple linear regression anal ysis revealed the v-wave, angiographic grading and systolic blood pres sure to be independent predictors of PVSFfr. PVSFfr differed in normal subjects, patients with 0-2+ and patients with 3-4+ regurgitation. PV SFfr is a valuable index in assessing mitral regurgitation. This index may be less dependent on equipment and operator than colour now imagi ng.