| The "proximal isovelocity surface area" method in assessing mitral valve area in patients with mitral stenosis and associated aortic regurgitation. | |
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MedLine Citation:
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PMID: 9199948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: This study compares the mitral valve area determined by Doppler color mapping of the proximal isovelocity surface area (PISA) and by Doppler pressure half-time with that obtained by two-dimensional planimetry in patients affected by mitral stenosis, with and without associated aortic regurgitation. Pressure half-time frequently overestimates the mitral valve area in patients with mitral stenosis and associated aortic regurgitation. PISA is an alternative method for determining mitral valve area in mitral stenosis and is not influenced by regurgitant lesions. METHODS: We studied 76 patients with mitral stenosis; aortic regurgitation > or = 2 was present in 24 patients. The PISA was recorded from the apex and the transmitral maximal flow rate, Q (ml/s), was calculated using the hemispheric equation Q = 2 pi R2 x AV x alpha/180, where R (cm) is the maximal radius of the PISA, AV (cm/s) is the aliasing velocity and alpha/180 is a correction factor accounting for the alpha inflow angle formed by the mitral leaflets. Mitral valve area, A (cm2), was calculated by continuity equation A = Q/V, where V (cm/s) is the peak transmitral flow velocity measured by continuous wave Doppler. RESULTS: The mitral valve area by two-dimensional planimetry (range 0.5-2.4 cm2; mean 1.33 +/- 0.41 cm2) was consistent with both PISA (r = 0.83; SEE 0.23 cm2) and pressure half-time (r = 0.79; SEE 0.25 cm2) methods. Similar agreement was found for the 36 patients with mitral regurgitation and for the 30 patients in atrial fibrillation. However, in patients with aortic regurgitation > or = 2, pressure half-time overestimated two-dimensional and PISA determined mitral valve areas by 0.24 +/- 0.25 cm2 (p < 0.01). CONCLUSIONS: In patients with mitral stenosis and significant aortic regurgitation, the PISA method is more accurate than pressure half-time in assessing mitral valve area. This method may be a reliable alternative when pressure half-time is affected by aortic regurgitation and two-dimensional planimetry images are unsuitable for anatomic evaluation. |
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Authors:
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G Centamore; A R Galassi; R Evola; L Lupo; A Galassi |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Giornale italiano di cardiologia Volume: 27 ISSN: 0046-5968 ISO Abbreviation: G Ital Cardiol Publication Date: 1997 Feb |
Date Detail:
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Created Date: 1997-08-01 Completed Date: 1997-08-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1270331 Medline TA: G Ital Cardiol Country: ITALY |
Other Details:
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Languages: eng Pagination: 133-40 Citation Subset: IM |
Affiliation:
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Divisione di Cardiologia Azienda Ospedaliera Cannizzaro, Catania. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Aortic Valve Insufficiency / ultrasonography* Atrial Fibrillation / physiopathology, ultrasonography Echocardiography Echocardiography, Doppler, Color Electrocardiography Female Humans Male Middle Aged Mitral Valve / ultrasonography* Mitral Valve Stenosis / ultrasonography* Observer Variation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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