COMPARISON OF THE USEFULNESS OF DOPPLER PRESSURE HALF-TIME IN MITRAL-STENOSIS IN PATIENTS LESS-THAN-65 AND GREATER-THAN-OR-EQUAL-TO-65 YEARS OF AGE

Doppler pressure half-time is a reliable method for estimating mitral valve area when net left atrial and ventricular compliance remain stab le. The accuracy of Doppler pressure half-time in estimating mitral va lve area in older patients is unknown. We studied 80 patients (65 wome n and 15 men, aged 56+/-14 years) with cardiac catheterization and ech ocardiography. Mitral valve area was calculated using the Gorlin formu la and by the Doppler pressure half-time method. Patients were stratif ied into those aged <65 years (n=57), and those aged greater than or e qual to 65 years (n=23). The discordance between pressure half-time an d Gorlin-derived mitral valve area wets assessed and related to multip le clinical, echocardiographic, and hemodynamic variables. The differe nce between pressure half-time and Gorlin-derived mitral valve area wa s greater in the older than inthe younger patient (0.34+/-0.30 vs 0.15 +/-0.27 cm(2), =0.009) bur the older group had smaller mitral valve ar eas by the Gorlin method (0.72+/-0.18 vs 0.89+/-0.32 cm(2), p=0.02) an d lower cardiac output. The difference between pressure half-time and Gorlin remained greater in the group of older patients (0.32+/-0.30 vs 0.19+/-0.22 cm(2), p=0.04), even when the analysis was restricted to patients with similar mitral valve area (<1 cm(2) by the Gorlin method ). Using multivariate analysis, age greater than or equal to 65 years remained the only significant predictor of the discrepancy between pre ssure half-time and Gorlin mitral valve area. Thus, when compared with Gorlin-derived mitral valve area, pressure half-time overestimated va lve area in older patients, and this technique for estimating mitral v alve area should be used with caution in patients greater than or equa l to 65 years of age. (C) 1996 by Excerpta Medica, Inc.