Estimation of Severity of Mitral Regurgitation by Digital Image Processing of Doppler Spectral Recordings

In order to test the hypothesis that the intensity of the regurgitant signal (RS) is indicative of severity of mitral regurgitation (MR), we digitized five well‐defined MR envelopes in 19 patients and calculated the mean pixel intensity (MPI) of the MR envelope and that of the diastolic inflow signal (DIF) using an offline computer system. The mean age of the patients was 49 years (range 19–78 years). The intensity of the RS was expressed as a ratio of the MPI of DIF (RSI DIF). This ratio was compared to the severity of MR determined by left ventricular angiography (LV angio). The ratio of the RSI DIF correlated well with the angiographic severity of MR (r = 0.9). A ratio of < 0.6 identified patients with moderate to severe MR and a ratio of < 0.6 correlated with mild MR (grade I and II) by LV angio. Our data indicate that MR severity assessed by measurement of the intensity of the RS correlates well with the angiographic determination of MR.