A SIMPLIFIED, PRACTICAL APPROACH TO ASSESSMENT OF SEVERITY OF MITRAL REGURGITATION BY DOPPLER COLOR-FLOW IMAGING WITH PROXIMAL CONVERGENCE - VALIDATION WITH CONCOMITANT CARDIAC-CATHETERIZATION

Objective: To compare the proximal convergence method for quantificati on of mitral regurgitation with findings on concomitant left ventricul ography. Material and Methods: In 41 patients (22 men and 19 women, 63 +/- 13 years of age), mitral regurgitation was evaluated concomitantl y by Doppler color flow jet area, proximal convergence method, and lef t ventriculography, A simplified measurement of the proximal convergen ce, consisting of the aliasing radius and velocity of the proximal iso surface (r(2) x V), was used. Results: Angiographic grade correlated w ell with the proximal convergence method (r(2) x V) but had poor corre lation with the Doppler color flow jet area method. All patients with a proximal convergence flow rate of less than 10 cm(3)/s had grade 1 o r 2 mitral regurgitation, whereas patients with a proximal convergence flow rate of more than 20 cm(3)/s had grade 3 or 4 mitral regurgitati on. The severity of mitral regurgitation was indeterminate in patients with proximal convergence flow rates from 10 to 20 cm(3)/s. Conclusio n: Doppler color flow jet area correlates pearly with angiographic gra de of mitral regurgitation. A simplified proximal convergence method i s useful for separating grade 3 and 4 from grade 1 and 2 mitral regurg itation in most patients. A group of patients with indeterminate sever ity of mitral regurgitation remains, however, in whom further assessme nt is necessary.