PEAK MITRAL INFLOW VELOCITY PREDICTS MITRAL REGURGITATION SEVERITY

Citation
L. Thomas et al., PEAK MITRAL INFLOW VELOCITY PREDICTS MITRAL REGURGITATION SEVERITY, Journal of the American College of Cardiology, 31(1), 1998, pp. 174-179
Citations number
39
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
07351097
Volume
31
Issue
1
Year of publication
1998
Pages
174 - 179
Database
ISI
SICI code
0735-1097(1998)31:1<174:PMIVPM>2.0.ZU;2-5
Abstract
Objectives. Mitral regurgitation (MR) is a common echocardiographic fi nding; however, there is no simple accurate method for quantification, The aim of this study was to develop an easily measured screening var iable for hemodynamically significant MR. Background. The added regurg itant volume in MR increases the left atrial to left ventricular gradi ent, which then increases the peak mitral inflow or the peak E wave ve locity, Our hypothesis was that peak E wave velocity and the E/A ratio increase in proportion to MR severity. Methods. We performed a retros pective analysis of 102 consecutive patients with varying grades of MR seen in the Adult Echocardiography Laboratory at the University of Ca lifornia, San Francisco. Peak E wave velocity, peak A wave velocity, E /A ratio and E wave deceleration time were measured in all patients, T he reference standard for MR was qualitative echocardiographic evaluat ion by an expert and quantitation of regurgitant fraction using two di mensional and Doppler echocardiography. Results. Peak E wave velocity was seen to increase in proportion to MR severity, with a significant difference between the different groups (F = 37, p < 0.0001), Peak E w ave velocity correlated with regurgitant fraction (r = 0.52, p < 0.001 ), Furthermore, an E wave velocity >1.2 m/s identified 24 of 27 patien ts with severe MR (sensitivity 86%, specificity 86%, positive predicti ve value 75%), An A wave dominant pattern excluded the presence of sev ere MR, The E/A ratio also increased in proportion to MR severity, Pea k A wave velocity and E wave deceleration time showed no correlation w ith MR severity. Conclusions. Peak E wave velocity is easy to obtain a nd is therefore widely applicable in clinical practice as a screening tool for evaluating MR severity. (C) 1998 by the American College of C ardiology.