Document Detail

Effective regurgitant orifice area: a noninvasive Doppler development of an old hemodynamic concept.
MedLine Citation:
PMID:  8294699     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to determine the feasibility, relation to other methods and significance of the effective regurgitant orifice area measurement. BACKGROUND: Assessment of the severity of valvular regurgitation (effective regurgitant orifice area) has not been implemented in clinical practice but can be made by Doppler echocardiography. METHODS: Effective regurgitant orifice area was calculated by Doppler echocardiography as the ratio of regurgitant volume/regurgitant jet time-velocity integral and compared with color flow Doppler mapping, angiography, surgical classification, regurgitant fraction and variables of volume overload. RESULTS: In 210 consecutive patients examined prospectively, feasibility improved from the early to the late experience (65% to 95%). Effective regurgitant orifice area was 28 +/- 23 mm2 (mean +/- SD) for aortic regurgitation (32 patients), 22 +/- 13 mm2 for ischemic/functional mitral regurgitation (50 patients) and 41 +/- 32 mm2 for organic mitral regurgitation (82 patients). Significant correlations were found between effective regurgitant orifice and mitral jet area by color flow Doppler mapping (r = 0.68 and r = 0.63, p < 0.0001, respectively) and angiographic grade (r = 0.77, p = 0.0004). Effective regurgitant orifice area in surgically determined moderate and severe lesions was markedly different in mitral regurgitation (35 +/- 12 and 75 +/- 33 mm2, respectively, p = 0.009) and in aortic regurgitation (21 +/- 8 and 38 +/- 5 mm2, respectively, p = 0.08). Strong correlations were found between effective regurgitant orifice area and variables reflecting volume overload. A logarithmic regression was found between effective regurgitant orifice area and regurgitant fraction, underlining the complementarity of these indexes. CONCLUSIONS: Calculation of effective regurgitant orifice area is a noninvasive Doppler development of an old hemodynamic concept, allowing assessment of the lesion severity of valvular regurgitation. Feasibility is excellent with experience. Effective regurgitant orifice area is an important and clinically significant index of regurgitation severity. It brings additive information to other quantitative indexes and its measurement should be implemented in the comprehensive assessment of valvular regurgitation.
M Enriquez-Sarano; J B Seward; K R Bailey; A J Tajik
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  23     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-02-25     Completed Date:  1994-02-25     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  443-51     Citation Subset:  AIM; IM    
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
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MeSH Terms
Aortic Valve / physiopathology
Aortic Valve Insufficiency / epidemiology,  physiopathology,  ultrasonography*
Blood Flow Velocity / physiology
Echocardiography, Doppler*
Feasibility Studies
Hemodynamics / physiology*
Mitral Valve / physiopathology
Mitral Valve Insufficiency / epidemiology,  physiopathology,  ultrasonography*
Prospective Studies
Signal Processing, Computer-Assisted*

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

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