Author + information
- Received August 7, 1991
- Revision received November 23, 1991
- Accepted December 13, 1991
- Published online June 1, 1992.
- Ramon Castello, MD∗,
- Patricia Lenzen, RDCS,
- Frank Aguirre, MD and
- Arthur J. Labovitz, MD, FACC
- ↵∗Address for reprints: Ramon Castello, MD, Division of Cardiology. 14th Floor, 3635 Vista Avenue at Grand Boulevard, Post Office Box 15250, Saint Louis, Missouri 63110-0250.
Eighty consecutive patients who underwent both left ventriculography and single-plane transesophageal echocardiography with Doppler color flow mapping were studied to compare the two techniques in the assessment of mitral regurgitation. Only the mosaic aspect of the regurgitant jet was included in the measurements. Values for inter- and intraobserver variability for the maximal regurgitant area measurements were 10 ± 9% and 9 ± 8%, respectively.
The best correlation between angiography and Doppler color flow imaging was obtained with the maximal regurgitant area (r = 0.90). A maximal regurgitant area <3 cm2predicted mild mitral regurgitation with a sensitivity of 96%, specificity of 100% and a predictive accuracy of 98%, whereas a maximal regurgitant area >6 cm2predicted severe mitral regurgitation with a sensitivity of 91%, a specificity of 100% and a predictive accuracy of 98%. A strong, although inferior, correlation was found for the maximal regurgitant area/left atrial area ratio (r = 0.81). A ratio <20% predicted mild mitral regurgitation with 94% accuracy, whereas a ratio >35% predicted severe mitral regurgitation with 85% accuracy.
Thus, single-plane transesophageal echocardiography with Doppler color flow mapping is an exquisitely sensitive technique for the diagnosis of mitral regurgitation. Minimal degrees of mitral regurgitation can be detected in approximately 62% of patients in whom no mitral regurgitation is detected by angiography. The mosaic maximal regurgitant area is a simple and easily obtainable Doppler echocardiographic index that provides an accurate estimation of mitral regurgitation severity.
- Received August 7, 1991.
- Revision received November 23, 1991.
- Accepted December 13, 1991.