Diagnostic value of color flow mapping and Doppler echocardiography in the quantification of mitral regurgitation in patients with mitral valve prolapse or rheumatic heart disease

• Autor(a) principal: Pinheiro, Aurelio Carvalho
• Data de Publicação: 2007
• Outros Autores: Neves Mancuso, Frederico Jose, Alli Hemerly, Daniela Fernanda, Kiyose, Alberto Takeshi, Campos, Orlando, Andrade, Jose Lazaro de, Vicenzo de Paola, Angelo Amato [UNIFESP], Camargo Carvalho, Antonio Carlos de, Moises, Valdir Ambrosio
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/00130000165rv
• DOI: 10.1016/j.echo.2007.02.029
• Texto Completo: http://dx.doi.org/10.1016/j.echo.2007.02.029; http://repositorio.unifesp.br/handle/11600/30049

Objectives: the objective was to analyze the diagnostic value of the echocardiographic methods used for quantification of mitral regurgitation (MR) in patients with mitral valve prolapse (MVP) or rheumatic heart disease (RHD).Methods: the study included 50 patients with MR (mean age of 46.1 years; 35 women), 27 (54%) with RHD and 23 (46%) with MVP. Quantification of the mitral valve regurgitation was obtained by regurgitant orifice area (ROA) and regurgitant volume (RV) by the flow convergence region (FCR) and two-dimensional Doppler echocardiographic methods, regurgitant fraction, jet area (JA), jet area/left atrial area ratio (JA/LAA), and vena contracta (VC). Patients were clinically followed to identify cardiovascular events. Data were analyzed by Pearson, kappa, and receiver operator characteristic curve tests; significance was defined as a P value less than .05.Results: the correlation between die two methods for ROA and RV were r = 0.79 and r = 0.80, respectively, and between these parameters and regurgitant fraction, VC, JA, and JA/LAA varied from r = 0.54 to r = 0.94 (P lt; .05); the agreement varied from kappa = 0.19 to kappa = 0.83. the highest accuracy to identify patients with clinically significant MR (events at follow-up) was 96% for ROA by FCR, 94% for VC, 86% for RV by FCR, and 86% for JA. No method showed a significant difference between MVP and RHD.Conclusions: the methods analyzed had significant correlation and good agreement. ROA by FCR and VC had the best performance to identify severe MR; no significant difference between MVP and RHD was observed.