Quantitative assessment of mitral regurgitation.
نویسنده
چکیده
Accurate quantitation of mitral regurgitation offers a major clinical dilemma. The clinical clues depend largely on cardiac auscultation, the accuracy of which needs to be rigorously tested (1). Mitral regurgitation may not be associated with a clinically audible systolic murmur, and the auscultatory features of severity of regurgitation are generally based on increased volume of diastolic flow across the mitral valve. The echocardiographic methods (2) used before widespread adoption of Doppler techniques provided indirect clues related to left ventricular and atrial chamber size and evidence of ventricular diastolic volume overload. Diagnosis of mitral regurgitation. The advent of Doppler methods has permitted detection of mitral regurgitation with a level of sensitivity not previously obtained (3-5). A systolic flow disturbance on the atrial side of the mitral valve, detected by pulsed Doppler technique, is used to diagnose the presence of mitral regurgitation. The potential errors of false positive diagnosis of mitral regurgitation by this approach may be avoided by placing the sample volume 2 I cm behind (i.e., posterosuperior) the plane of the mitral anulus and requiring a pansystolic or late systolic flow disturbance generally associated with aliasing. Specifically, a brief early systolic flow disturbance at the time of closure or doming of the mitral valve leaflets can be a normal occurrence. The incidence of mitral regurgitation in normal subjects or in the absence of disease or dysfunction of the mitral apparatus appears to be ~5%. Quantitation of mitral regurgitation. The pulsed Doppler method has also been used to provide information regarding quantitation of mitral regurgitation. The regurgitation jet may be mapped by moving the Doppler sample volume progressively deeper into the left atrium. The atrium can be divided into nine compartments by considering divisions approximating one-third in the two dimensions of a cross-
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ورودعنوان ژورنال:
- Journal of the American College of Cardiology
دوره 13 3 شماره
صفحات -
تاریخ انتشار 1989