Assessment of minimal mitral regurgitation: comparative study with Doppler echocardiography and ventriculography.

This study was designed to assess color Doppler echocardiographic parameters in subjects with minimal mitral regurgitation (MR) in an otherwise normal heart. Study cases were selected during a five month period from 2500 young males with an echocardiographic indication on the basis of subjects' complaints and physical examination. Left ventriculography was performed and subjects were dichotomized into group-1 (n = 30) if there was angiographically MR and into group-2 (n = 30) if they were intact. Patients in group-1 were described as to have 'true MR' and MR flow in group-2 was named 'physiological'. Doppler echocardiographic variables of true and physiological MR are compared to each other. The following echocardiographic variables were significantly different between group-1 and group-2: 1) the ratio of the max. duration of MR/mean systolic interval in parasternal long axis (0.710 +/- 0.244 vs 0.430 +/- 0.268, respectively, p < 0.001), 2) the ratio of the maximum duration of MR/mean systolic interval in apical four chamber view (0.550 +/- 0.361 vs 0.317 +/- 0.272 respectively, p = 0.007), 3) the peak velocity of the regurgitant flow in parasternal log axis (180 +/- 77 vs 120 +/- 69, respectively, p = 0.003), 4) the regurgitant jet area in parasternal long axis (0.813 +/- 0.651 vs 0.411 +/- 0.431, respectively, p = 0.007). The maximal duration of MR/mean systolic time interval > or = 0.6, regurgitant jet area > or = 0.4 cm2, and regurgitant peak velocity > or = 130 cm/sec. in parasternal long axis dichotomize the cases into true with a predictive value of 76%, 67% and 63%, respectively.