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European Heart Journal 1996 17(8):1256-1264;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

Influence of the mechanism of regurgitation on the quantification of mitral regurgitation by the proximal flow convergence method and the jet area method

G. Grossmann, M. Giesler, A. Schmidt, M. Kochs, S. Wieshammer, M. Höher, C. Felder and V. Hombach

Department of Internal Medicine, Division of Cardiology, University of Ulm Ulm, Germany

revised 5 January 1996; accepted 5 January 1996.

Correspondence: Georg Grossmann, Department of Internal Medicine, Division of Cardiology, University of Ulm, Robert Koch Strasse 8, 89081 Ulm, Germany

Abstract

In 84 patients mitral regurgitation was quantified by angiography. The mechanism of regurgitation was determined by echocardiography (organic, n=54, functional, n=30). The radii of the proximal isovelocity surface areas in the flow convergence region for 28 and 41 cm. s–1 blood flow velocity and the area and length of the regurgitant jet were measured using colour flow Doppler imaging. The radii of the proximal isovelocity surface areas correlated more closely with the angiographic grade than the jet parameters irrespective of the mechanism of regurgitation. In more than 90% of the patients, grades I–II mitral regurgitation were correctly differentiated from grades III–IV by means of the radii of the proximal isovelocity surface areas. Using the jet parameters, the differentiation was correct in 50–90% of the patients depending on the mechanism of regurgitation. The jet area method particularly failed to identify grades III–IV organic mitral regurgitation due to a high prevalence of eccentric jets in these patients.

It is concluded that the proximal flow convergence method was suitable for the quantification of mitral regurgitation irrespective of the mechanism of mitral regurgitation. On the other hand, the value of the jet area method depended largely on the regurgitation mechanism.

Key Words: Mitral regurgitation • colour flow Doppler imaging • proximal flow convergence region • proximal isovelocity surface area • regurgitant jet area


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