What does this research mean for the field?

A pulsed Doppler-derived mitral to aortic velocity-time integral (VTI) ratio of ≥1.3 accurately identifies severe mitral regurgitation with 87% sensitivity and 91% specificity, correlating well with angiographic grading independent of jet geometry. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the clinical utility of the pulsed Doppler mitral to aortic velocity-time integral (VTI) ratio for semiquantitative assessment of isolated pure mitral regurgitation severity.

August 31, 2026European Heart JournalOpen Access

Mitral to aortic velocity-time integral ratio

Q: What are the key findings of this study?

A mitral to aortic VTI ratio ≥1.3 identified severe mitral regurgitation with 87% sensitivity and 91% specificity, and correlated well with angiographic grading (r=0.74, P<0.001).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Isolated pure mitral regurgitation (n=159). Intervention: Mitral to aortic velocity-time integral (VTI) ratio vs. Controls without valvular disease. Primary outcome: Angiographic grading of mitral regurgitation (r=0.74, p=<0.001).

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Key result

Mitral to aortic VTI ratio ≥1.3 reliably identifies severe MR and correlates with angiographic grading.

r=0.74
P<0.001
n=159

Why the study?

The clinical value of the mitral to aortic velocity-time integral ratio as a simple, non-geometric pulsed Doppler index for assessing the severity of isolated pure mitral regurgitation needed to be determined.

Does the mitral to aortic VTI ratio accurately assess the severity of isolated pure mitral regurgitation compared to angiographic grading?

Comparison

Mitral to aortic VTI ratio vs angiographic MR grade and haemodynamic regurgitant fraction

Design

Prospective cross-sectional study

Authors

CTChristophe TribouilloyCardiac Imaging WSWei Feng ShenQingdao Agricultural University JRJean-Luc ReyCentre Hospitalier Universitaire Amiens-Picardie

Discussion

Member takes

Implication

Supports mitral-to-aortic VTI ratio for MR grading; leaves open prospective validation before routine adoption.

Key Points

To determine the clinical utility of the pulsed Doppler mitral to aortic velocity-time integral (VTI) ratio for semiquantitative assessment of isolated pure mitral regurgitation severity.
Prospective Doppler echocardiography performed within 48 hours of cardiac catheterization in 109 patients with isolated pure mitral regurgitation in sinus rhythm.
Evaluated 50 healthy controls and compared VTI ratios against angiographic grading (n=109) and hemodynamic regurgitant fraction (n=91).
Mitral to aortic VTI ratio correlated with angiographic grade (r = 0.74, P < 0.001), where a ratio ≥ 1.3 identified severe regurgitation (grade III or IV) with 87% sensitivity and 91% specificity.
VTI ratio correlated with regurgitant fraction (r = 0.73, P < 0.001), with a cutoff ≥ 1.3 identifying a regurgitant fraction ≥ 40% with 90% sensitivity and 85% specificity regardless of jet eccentricity.

Study Design

Type

Cross-Sectional (n=159)

Structured PICO

Does the mitral to aortic VTI ratio accurately assess the severity of isolated pure mitral regurgitation compared to angiographic grading?

Population

159 participants, including 109 with isolated pure mitral regurgitation in sinus rhythm and 50 controls, evaluated with Doppler echocardiography and cardiac catheterization.

Exposure

Pulsed Doppler echocardiography to measure the mitral to aortic velocity-time integral (VTI) ratio.

Comparator

Angiographic grading of MR and haemodynamic regurgitant fraction derived from cardiac catheterization.

Outcome

Correlation between the mitral to aortic VTI ratio and the angiographic grading of MR or haemodynamic regurgitant fraction.surrogate

Main Result

Effect estimate: r=0.74

p-value: p=<0.001

The pulsed Doppler-derived mitral to aortic VTI ratio is a simple, accurate, and geometry-independent index for assessing the severity of isolated pure mitral regurgitation.

Cite This Study

Tribouilloy et al. (1994) conducted a cross-sectional in Isolated pure mitral regurgitation (n=159). Mitral to aortic velocity-time integral (VTI) ratio vs. Controls without valvular disease was evaluated on Angiographic grading of mitral regurgitation (r=0.74, p=<0.001). A mitral to aortic VTI ratio ≥1.3 identified severe mitral regurgitation with 87% sensitivity and 91% specificity, and correlated well with angiographic grading (r=0.74, P<0.001).

synapsesocial.com/papers/6a959b59e09b73fec4b2a08c https://doi.org/10.1093/oxfordjournals.eurheartj.a060390

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Mitral to aortic velocity-time integral ratio

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Mitral to aortic velocity-time integral ratio

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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