| Peak mitral inflow velocity predicts mitral regurgitation severity. | |
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MedLine Citation:
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PMID: 9426037 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Mitral regurgitation (MR) is a common echocardiographic finding; however, there is no simple accurate method for quantification. The aim of this study was to develop an easily measured screening variable for hemodynamically significant MR. BACKGROUND: The added regurgitant volume in MR increases the left atrial to left ventricular gradient, which then increases the peak mitral inflow or the peak E wave velocity. Our hypothesis was that peak E wave velocity and the E/A ratio increase in proportion to MR severity. METHODS: We performed a retrospective analysis of 102 consecutive patients with varying grades of MR seen in the Adult Echocardiography Laboratory at the University of California, San Francisco. Peak E wave velocity, peak A wave velocity, E/A ratio and E wave deceleration time were measured in all patients. The reference standard for MR was qualitative echocardiographic evaluation by an expert and quantitation of regurgitant fraction using two-dimensional 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 wave velocity correlated with regurgitant fraction (r = 0.52, p < 0.001). Furthermore, an E wave velocity >1.2 m/s identified 24 of 27 patients with severe MR (sensitivity 86%, specificity 86%, positive predictive value 75%). An A wave dominant pattern excluded the presence of severe MR. The E/A ratio also increased in proportion to MR severity. Peak A wave velocity and E wave deceleration time showed no correlation with MR severity. CONCLUSIONS: Peak E wave velocity is easy to obtain and is therefore widely applicable in clinical practice as a screening tool for evaluating MR severity. |
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Authors:
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L Thomas; E Foster; N B Schiller |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 31 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1998 Jan |
Date Detail:
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Created Date: 1998-01-27 Completed Date: 1998-01-27 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 174-9 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, University of California San Francisco, 94142-0214, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Echocardiography, Doppler Hemodynamics Humans Middle Aged Mitral Valve Insufficiency / physiopathology*, ultrasonography* Retrospective Studies Ventricular Function, Left |
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