Author + information
- Received April 11, 1983
- Revision received May 23, 1983
- Accepted May 23, 1983
- Published online October 1, 1983.
- Jian-Fang Ren, MD,
- Morris N. Kotler, MD, FACC*,
- Nicholas L. Depace, MD,
- Gary S. Mintz, MD, FACC,
- Demetrios Kimbiris, MD, FACC,
- Peter Kalman, MD, FACC and
- John Ross, RCPT
- ↵*Address for reprints: Morris N. Kotler, MD, Hahnemann University, M.S. 110, 230 North Broad Street, Philadelphia, Pennsylvania 19102.
Several noninvasive techniques, including radionuclide angiography and Doppler echocardiography, have attempted to measure the regurgitant volume in patients with mitral regurgitation; however, none of these techniques are entirely satisfactory. Utilizing a computerized light pen method for tracing the left atrial endocardial border during systole and diastole in two orthogonal planes (apical four and two chamber views), biplane volume determinations were calculated in 12 normal subjects and 30 patients with nonrheumatic mitral regurgitation. Left atrial emptying volume determinations were performed by subtracting the left atrial end-diastolic volume from the left atrial end-systolic volume. The degree of mitral regurgitation was visually assessed as normal (0, trivial, Group I, 12 patients), mild (1 +, Group II, 4 patients), moderate (2 + , Group III, 8 patients), moderately severe (3 + , Group IV, 12 patients) and severe (4 +, Group V, 6 patients) by contrast left ventricular angiography and also quantitatively by regurgitant fraction at cardiac catheterization.
All 18 patients with moderately severe (Group IV) and severe (Group V) mitral regurgitation had a left atrial emptying volume greater than 40 ml compared with none of the normal subjects and patients with mild (Group II) or moderate (Group III) mitral regurgitation. There was good correlation between left atrial emptying volume and mitral regurgitant fraction ( r = 0.85, p < 0.01). Thus, in patients with nonrheumatic mitral regurgitation, left atrial emptying volume is useful in separating mild from severe mitral regurgitation.
This material was presented in part at the Third Meeting of World Federation for Ultrasound in Medicine and Biology in Brighton, England, July 30, 1982.
- Received April 11, 1983.
- Revision received May 23, 1983.
- Accepted May 23, 1983.
- American College of Cardiology Foundation