Abstract
Background. Quantitation of valvular regurgitation remains a challenge. The accuracy of quantitative Doppler is controversial, and its ability to measure regurgitant volume is unknown; therefore, it is not widely used. Methods and Results. In 120 patients (20 without regurgitation, 19 with aortic regurgitation, and 81 with mitral regurgitation), the stroke volume through the mitral annulus and left ventricular outflow tract were measured using pulsed-wave Doppler concurrently with left ventricular stroke volume calculated using left ventricular volumes measured by two-dimensional echocardiography Simpson's biapical method. Regurgitant volume and fraction were thus computed using Doppler or ventricular methods. In normal patients there were good correlations between Doppler and left ventricular measurements of stroke volume. Doppler regurgitant volume and fraction were 4.4±4.4 mL and 5.3±4.5%, respectively. In patients with aortic regurgitation, there were good correlations between Doppler and left ventricular measurements of stroke volume, regurgitant volume, and regurgitant fraction (r=0.97, r=0.95, and r=0.93, respectively; p<0.0001). In patients with mitral regurgitation, despite good correlations between Doppler and ventricular methods for stroke volume, regurgitant volume, and regurgitant fraction (r=0.94, r=0.93, and r=0.94, respectively; p<0.001), these variables were overestimated by Doppler. However, in the last 54 patients compared with the first 27, overestimation decreased significantly for regurgitant volume (5±10 mL versus 18±27 mL, p<0.05) and regurgitant fraction (3.3±6.7% versus 6.2±6.8%, p=0.05). Conclusions. Quantitative Doppler can be performed in large numbers of patients in a clinical laboratory. Its potential limitation was identified as overestimation of mitral regurgitation, which is overcome with increased experience. Its achieved accuracy in mitral and aortic regurgitation allows measurement not only of regurgitant fraction but most importantly of regurgitant volume.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 841-848 |
| Number of pages | 8 |
| Journal | Circulation |
| Volume | 87 |
| Issue number | 3 |
| State | Published - 1993 |
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Keywords
- aortic regurgitation
- echocardiographic left ventricular volume
- mitral regurgitation
- regurgitant fraction
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Quantitative Doppler assessment of valvular regurgitation. / Sarano, Maurice E; Bailey, Kent R; Seward, J. B.; Tajik, A. J.; Krohn, M. J.; Mays, J. M.
In: Circulation, Vol. 87, No. 3, 1993, p. 841-848.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Quantitative Doppler assessment of valvular regurgitation
AU - Sarano, Maurice E
AU - Bailey, Kent R
AU - Seward, J. B.
AU - Tajik, A. J.
AU - Krohn, M. J.
AU - Mays, J. M.
PY - 1993
Y1 - 1993
N2 - Background. Quantitation of valvular regurgitation remains a challenge. The accuracy of quantitative Doppler is controversial, and its ability to measure regurgitant volume is unknown; therefore, it is not widely used. Methods and Results. In 120 patients (20 without regurgitation, 19 with aortic regurgitation, and 81 with mitral regurgitation), the stroke volume through the mitral annulus and left ventricular outflow tract were measured using pulsed-wave Doppler concurrently with left ventricular stroke volume calculated using left ventricular volumes measured by two-dimensional echocardiography Simpson's biapical method. Regurgitant volume and fraction were thus computed using Doppler or ventricular methods. In normal patients there were good correlations between Doppler and left ventricular measurements of stroke volume. Doppler regurgitant volume and fraction were 4.4±4.4 mL and 5.3±4.5%, respectively. In patients with aortic regurgitation, there were good correlations between Doppler and left ventricular measurements of stroke volume, regurgitant volume, and regurgitant fraction (r=0.97, r=0.95, and r=0.93, respectively; p<0.0001). In patients with mitral regurgitation, despite good correlations between Doppler and ventricular methods for stroke volume, regurgitant volume, and regurgitant fraction (r=0.94, r=0.93, and r=0.94, respectively; p<0.001), these variables were overestimated by Doppler. However, in the last 54 patients compared with the first 27, overestimation decreased significantly for regurgitant volume (5±10 mL versus 18±27 mL, p<0.05) and regurgitant fraction (3.3±6.7% versus 6.2±6.8%, p=0.05). Conclusions. Quantitative Doppler can be performed in large numbers of patients in a clinical laboratory. Its potential limitation was identified as overestimation of mitral regurgitation, which is overcome with increased experience. Its achieved accuracy in mitral and aortic regurgitation allows measurement not only of regurgitant fraction but most importantly of regurgitant volume.
AB - Background. Quantitation of valvular regurgitation remains a challenge. The accuracy of quantitative Doppler is controversial, and its ability to measure regurgitant volume is unknown; therefore, it is not widely used. Methods and Results. In 120 patients (20 without regurgitation, 19 with aortic regurgitation, and 81 with mitral regurgitation), the stroke volume through the mitral annulus and left ventricular outflow tract were measured using pulsed-wave Doppler concurrently with left ventricular stroke volume calculated using left ventricular volumes measured by two-dimensional echocardiography Simpson's biapical method. Regurgitant volume and fraction were thus computed using Doppler or ventricular methods. In normal patients there were good correlations between Doppler and left ventricular measurements of stroke volume. Doppler regurgitant volume and fraction were 4.4±4.4 mL and 5.3±4.5%, respectively. In patients with aortic regurgitation, there were good correlations between Doppler and left ventricular measurements of stroke volume, regurgitant volume, and regurgitant fraction (r=0.97, r=0.95, and r=0.93, respectively; p<0.0001). In patients with mitral regurgitation, despite good correlations between Doppler and ventricular methods for stroke volume, regurgitant volume, and regurgitant fraction (r=0.94, r=0.93, and r=0.94, respectively; p<0.001), these variables were overestimated by Doppler. However, in the last 54 patients compared with the first 27, overestimation decreased significantly for regurgitant volume (5±10 mL versus 18±27 mL, p<0.05) and regurgitant fraction (3.3±6.7% versus 6.2±6.8%, p=0.05). Conclusions. Quantitative Doppler can be performed in large numbers of patients in a clinical laboratory. Its potential limitation was identified as overestimation of mitral regurgitation, which is overcome with increased experience. Its achieved accuracy in mitral and aortic regurgitation allows measurement not only of regurgitant fraction but most importantly of regurgitant volume.
KW - aortic regurgitation
KW - echocardiographic left ventricular volume
KW - mitral regurgitation
KW - regurgitant fraction
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UR - http://www.scopus.com/inward/citedby.url?scp=0027411045&partnerID=8YFLogxK
M3 - Article
VL - 87
SP - 841
EP - 848
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 3
ER -