[Quantification of mitral regurgitation using Doppler echocardiography].

Abstract

Examining 18 patients without regurgitation (control group) and 20 patients with mitral regurgitation the method of Doppler echokardiography, the pulsating and continual wave, was applied. Both groups consisted of patients with heart diseases in whom a heart catheterization was indicated for the evaluation of the actual state. Thus, the competence of the mitral orifice was also evaluated. The aim of the investigation was to quantify or more accurately estimate the degree of mitral regurgitation. The accuracy of the Doppler method was tested by means of the measured cardiac stroke volumes of the right heart side in both groups with the probability higher than 80% but lower than 90% (0.80 less than p 0.23 less than 0.90), and by testing the cardiac stroke volumes of the right heart and the diastolic volumes of the left heart (control group: mitral and pulmonal orifice) with the probability higher than 70% and lower than 80% with the error of 6% of the measured volume. The regurgitation mitral fraction (RF) was presented as the difference between the total forwards volume (TFV) in the mitral orifice and the net forwards volume (NFV) in the pulmonal orifice and calculated in cm3, and as the regurgitation fraction index (RFI) in percentages (RFI = 1--NFV/TFV). It was also expressed as the regurgitation volume index (RVI) whose values were divided into degrees, according to the literature data. Numerical values of the regurgitation fraction and the regurgitation fraction index were classified in the mitral insufficiency degrees from 1 to 4. A fast regurgitation screening was possible due to the regurgitation fraction index, which is lower than the 45% of the diastolic volume in the cases of mild mitral insufficiency, while the values over 45% denote severe mitral insufficiency. The obtained values of the regurgitation fraction and index divided into degrees showed a close correlation with the angioventriculographic degrees obtained by heart catheterization. Cardiac output measured by the Doppler and Fick methods in the group with regurgitation showed a high correlation coefficient (r = 0.85) (0.60 less than p 0.47 less than 0.70).