Document Detail


Comparison of quantitative and semiquantitative methods for assessing mitral regurgitation by transesophageal echocardiography.
MedLine Citation:
PMID:  11137836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Semiquantitative grading of mitral regurgitation (MR) by transesophageal echocardiography (TEE) is widely used for clinical decision making. However, the relation between semiquantitative grading by biplane or multiplane TEE and quantitative measures remains undetermined. Biplane or multiplane TEE was performed in 113 patients in the operating room. MR severity was graded from 1 to 4+ by Doppler color flow mapping. MR was quantified using the thermodilution-Doppler method as mitral regurgitant stroke volume (RSV) derived from the difference between total mitral inflow measured by pulsed Doppler and forward flow measured by thermodilution. Mitral regurgitant orifice area (ROA) was calculated by RSV divided by mitral regurgitant velocity. RSV and ROA were also calculated using the proximal isovelocity surface area method. RSV and ROA significantly correlated with the semiquantitative grading either by TEE or angiogram in a nonlinear fashion, with the best fit being given by an exponential model with correlation coefficients from 0.73 to 0.87 (p <0.001). Substantially increased RSV and ROA were observed in MR grades of > or =3+. In the same grades of 3+ or 4+ MR, the largest RSV was 4 times larger than the smallest (190 to 220 vs 44 to 45 ml), and the largest ROA (1.82 to 2.0 vs 0.26 to 0.27 cm2) was sixfold larger than the smallest. Patients with 2 to 3+ MR had significantly variable RSV and ROA (range 21 to 91 ml and 0.12 to 0.65 cm2, respectively). Color flow mapping by biplane or multiplane TEE or angiography is able to categorize precisely mild (< or =2+) and severe (> or =3+) MR, but cannot accurately determine actual hemodynamic load of MR in more severe degrees of MR.
Authors:
M Pu; J D Thomas; P M Vandervoort; W J Stewart; D M Cosgrove; B P Griffin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  87     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-30     Completed Date:  2001-02-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  66-70     Citation Subset:  AIM; IM; S    
Affiliation:
Cardiovascular Imaging Center, Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195-5064, USA.
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MeSH Terms
Descriptor/Qualifier:
Echocardiography, Transesophageal / methods*
Female
Hemodynamics / physiology
Humans
Male
Middle Aged
Mitral Valve Insufficiency / physiopathology,  ultrasonography*
Stroke Volume / physiology
Thermodilution

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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