Doppler Echocardiographic Correlation of Pulmonary Venous Flow Patterns to Mitral Valve Regurgitant Severity in Patients With Atrial Fibrillation

Studies have shown that pulmonary systolic velocities are decreased in patients with atrial fibrillation, but none have shown the correlation between mitral valve regurgitant severity and the amount of systolic flow decrease/reversal in these patients. In patients with normal sinus rhythm, a finding of decreased systolic flow <0.4 m/s is consistent with moderate mitral regurgitation, and systolic flow reversal is consistent with severe mitral regurgitation. Doppler recordings of 66 patients who were in atrial fibrillation at the time of their transthoracic echocardiograms (January-July 1995, January 1996-February 1997) were analyzed to show the statistical relation between mitral regurgitant severity and the amount of systolic flow decrease/reversal. This study showed that a decrease in systolic flow velocities expected in patients with atrial fibrillation and the amount of decrease does not correlate statistically with the severity of mitral regurgitant lesions. In addition, flow reversal in the pulmonary veins is not expected in patients with atrial fibrillation, and such a finding is strongly associated with severe mitral regurgitant lesions.