Author + information
- Received February 4, 1985
- Revision received June 11, 1985
- Accepted August 5, 1985
- Published online January 1, 1986.
- Kunio Miyatake, MDa,
- Shiro Izumi, MD,
- Mitsunori Okamoto, MD*,
- Naokazu Kinoshita, MD,
- Hirohiko Asonuma, MD,
- Hiroshi Nakagawa, MD,
- Katsuhiro Yamamoto, MD,
- Makoto Takamiya, MD,
- Hiroshi Sakakibara, MD and
- Yasuharu Nimura, MD, MSc
- ↵aAddress for reprints: Kunio Miyatake, MD, National Cardiovascular Center, 7-1, Fujishiro-dai 5-chome, Suita, Osaka 565, Japan.
An attempt was made to determine whether mitral regurgitation could be detected and its severity evaluated semiquantitatively by newly developed real-time twodimensional Doppler flow imaging in 109 patients who underwent left ventriculography. In the Doppler flow imaging technique, Doppler signals due to blood flow in the cardiac chambers are processed using a high speed autocorrelation technique, so that the direction, velocity and turbulence of the intracardiac blood flow are displayed in the color-coded mode on the monochrome B-mode echocardiogram in real time. Mitral regurgitant flow was imaged as a jet spurting out from the mitral valve orifice into the left atrial cavity. It was noted that the regurgitant jet in the left atrial cavity had a variety of orientations and dynamic features when studied by the present technique. The sensitivity of the technique in the detection of mitral regurgitation was 86% as compared with that of left ventriculography. Mitral regurgitation in the false negative cases was mostly mild.
On the basis of the farthest distance reached by the regurgitant flow signal from the mitral valve orifice, the severity of regurgitation was graded on a four point scale and these results were compared with those of angiography. A significant correlation (r = 0.87) was found between Doppler imaging and angiography in the evaluation of the severity of mitral regurgitation. A similar result was obtained for the evaluation based on the area covered by the regurgitant signals in the left atrial cavity. Thus, noninvasive semiquantitative evaluation by realtime two-dimensional Doppler flow imaging appears to be a promising clinical technique.
↵* Present address: First Department of Medicine, Hiroshima University School of Medicine, Hiroshima, Japan.
This study was supported in part by a Grant-in-Aid for Development of Scientific Research (59870034) from the Ministry of Education, Science and Culture of Japan, Tokyo, Japan in 1984 and 1985.
- Received February 4, 1985.
- Revision received June 11, 1985.
- Accepted August 5, 1985.
- American College of Cardiology Foundation