Quantification of Mitral Regurgitation

نویسندگان

  • Chunguang Chen
  • Pamela Harrigan
  • Robert A. Levine
چکیده

Background. In clinical color Doppler examinations, mitral regurgitant jets are often observed to impinge on the left atrial wall immediately beyond the mitral valve. In accordance with fluid dynamics theory, we hypothesized that a jet impinging on a wall would lose momentum more rapidly, undergo spatial distortion, and thus have a different observed jet area from that of a free jet with an identical flow rate. Methods and Results. To test this hypothesis in vivo, we studied 44 patients with mitral regurgitation -30 with centrally directed free jets and 14 with eccentrically directed impinging wall jets. Maximal color jet areas (cm2) (with and without correction for left atrial size) were correlated with mitral regurgitant volumes, flow rates, and fractions derived from pulsed Doppler mitral and aortic forward flows. The groups were compared by analysis of covariance. Mean+SD mitral regurgitant fraction, regurgitant volume, and mean flow rate averaged 37±17%, 3.06±2.65 1/min, and 147±118 ml/sec, respectively. The maximal jet area from color Doppler imaging correlated relatively well with the mitral regurgitant fraction in the patients with free mitral regurgitant jets (r=0.74, p<O0.0O1) but poorly in the patients with impinging wall jets (r=0.42, p=NS). Although the mitral regurgitant fraction was larger (p<0.05) in patients with wall jets (44±20%1) than in those with free jets (33+15%), the maximal jet area

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تاریخ انتشار 2005