Key result
Left ventricular failure, not mitral incompetence, drives clinical criteria for disease severity.
Why the study?
Current criteria for assessing severity of mitral valve disease are influenced by left ventricular failure rather than mitral incompetence itself, questioning their optimality for surgical decisions.
Observational (n=39)
Permits quantitative regurgitant flow assessment in mitral valve disease; leaves open validation against modern standards before clinical adoption.
A direct indicator-dilution principle for measurement of regurgitant flow has been applied in the study of 39 patients with mitral valve disease. Certain technical modifications in the procedure appear to have abolished the grossly anomalous results encountered previously, enabling a degree of reliance to be placed on the quantitative measurement. With use of the measurement obtained, together with other hemodynamic data, the functional status of patients with mitral incompetence has been analyzed. The findings confirm that left ventricular failure, not mitral incompetence itself, underlies many of the criteria presently used to determine the severity of the disease, i.e., the presence of symptoms, the clinical and radiologic signs, and abnormalities in arterial dye dilution curves. These criteria are therefore probably not optimal ones on which to base selection of patients for surgical treatment, or to follow its results.
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Jose et al. (1962) conducted an observational in Mitral valve disease (n=39). Direct indicator-dilution measurement of regurgitant flow was evaluated on Determinants of disease severity criteria (symptoms, clinical and radiologic signs). Hemodynamic analysis using direct indicator-dilution showed that left ventricular failure, not mitral incompetence, underlies the clinical criteria used to determine disease severity.
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