QUANTIFICATION OF MITRAL REGURGITATION BY DOPPLER-ECHOCARDIOGRAPHY - CORRELATIONS WITH CINEANGIOGRAPHY IN 60 PATIENTS

Non-invasive quantification of mitral regurgitation remains a clinical problem. The aim of this study was to assess a new methodology of Dop pler echocardiographic assessment of the mitral regurgitant fraction. The study included 60 patients (average age 61 years) in sinus rhythm with mitral regurgitation. The cardiac output was measured by Doppler echocardiography at four sites : the aortic, pulmonary and mitral ring s and at the tips of the mitral leaflets by a method previously valida ted and published. Using the average of the aortic and pulmonary cardi ac outputs on the hand and the mitral cardiac output on the other, it was possible to calculate the regurgitant fraction : (mean mitral flow - mean aortic/pulmonary flow)/mean mitral flow. This was correlated w ith the Sellers angiographic grades of regurgitation. The results conf irm this validated procedure : the correlation of aortic and pulmonary flows was good : r = 0.94. This also held true for mitral flow at the two sites : r = 0.96. The correlation between the Doppler echocardiog raphic regurgitant fraction and the angiographic estimation of the sev erity of mitral regurgitation was good : r = 0.89. There was a statist ically significant difference between the Doppler echocardiographic re gurgitant fractions corresponding to Sellers Grades I, II and III mitr al regurgitation (p 0.0001). This study shows that Doppler echocardiog raphic measurements of blood flow at different orifices of the heart a pplied to the quantification of mitral regurgitation is a reliable met hod, the use of which, with strict methodological criteria, may be pro posed in everyday clinical practice.