Document Detail


The Mitral Regurgitation Index: an echocardiographic guide to severity.
MedLine Citation:
PMID:  10362208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to develop a semiquantitative index of mitral regurgitation severity suitable for use in daily clinical practice and research. BACKGROUND: There is no simple method for quantification of mitral regurgitation (MR). The MR Index is a semiquantitative guide to MR severity. The MR Index is a composite of six echocardiographic variables: color Doppler regurgitant jet penetration and proximal isovelocity surface area, continuous wave Doppler characteristics of the regurgitant jet and tricuspid regurgitant jet-derived pulmonary artery pressure, pulse wave Doppler pulmonary venous flow pattern and two-dimensional echocardiographic estimation of left atrial size. METHODS: Consecutive patients (n = 103) with varying grades of MR, seen in the Adult Echocardiography Laboratory at UCSF, were analyzed retrospectively. All patients were evaluated for the six variables, each variable being scored on a four point scale from 0 to 3. The reference standards for MR were qualitative echocardiographic evaluation by an expert and quantitation of regurgitant fraction using two-dimensional and Doppler echocardiography. A subgroup of patients with low ejection fraction (EF < 50%) were also analyzed. RESULTS: The MR Index increased in proportion to MR severity with a significant difference among the three grades in both normal and low EF groups (F = 130 and F = 42, respectively, p < 0.0001). The MR Index correlated with regurgitant fraction (r = 0.76, p < 0.0001). An MR Index > or =2.2 identified 26/29 patients with severe MR (sensitivity = 90%, specificity = 88%, PPV = 79%). No patient with severe MR had an MR Index <1.8 and no patient with mild MR had an MR Index >1.7. CONCLUSIONS: The MR Index is a simple semiquantitative estimate of MR severity, which seems to be useful in evaluating MR in patients with a low EF.
Authors:
L Thomas; E Foster; J I Hoffman; N B Schiller
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  33     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-06-22     Completed Date:  1999-06-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2016-22     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of California, San Francisco 94143-0214, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Flow Velocity
Echocardiography, Doppler, Color*
Female
Humans
Male
Middle Aged
Mitral Valve Insufficiency / physiopathology,  ultrasonography*
Observer Variation
Predictive Value of Tests
Pulmonary Wedge Pressure
Retrospective Studies
Severity of Illness Index
Stroke Volume

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


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