A regurgitant jet diameter of ≥5.5 mm measured by transesophageal Doppler identified severe mitral regurgitation with 92% sensitivity and 92% specificity.
Cross-Sectional (n=63)
Does measuring regurgitant jet width at its origin with transesophageal Doppler color flow imaging accurately assess the severity of mitral regurgitation compared to cardiac catheterization?
Measuring the regurgitant jet width at its origin using transesophageal Doppler color flow imaging provides a simple and highly accurate method for assessing the severity of mitral regurgitation.
Effect estimate: r = 0.86
p-value: p=<0.001
BACKGROUND: The ability of transesophageal color Doppler echocardiography to provide high-resolution images of both cardiac structure and blood flow in real time is advantageous for many clinical purposes. This study was performed to determine the utility of the regurgitant jet width at its origin measured by transesophageal Doppler color flow imaging in the assessment of severity of mitral regurgitation. METHODS AND RESULTS: Sixty-three consecutive patients with mitral regurgitation underwent transesophageal color Doppler examination, and the diameter of regurgitant jet at its origin was measured. Both right and left cardiac catheterizations were performed within 24 hours of Doppler studies, and angiographic grading of mitral regurgitation and regurgitant stroke volume were evaluated. There was a close relation between the jet diameter at its origin measured by transesophageal Doppler color flow imaging and the angiographic grade of mitral regurgitation (r = 0.86, p less than 0.001). A jet diameter of 5.5 mm or more identified severe mitral regurgitation (grade III or IV) with a sensitivity of 92%, specificity of 92%, and positive and negative predictive values of 88% and 95%, respectively. In 31 patients with isolated mitral regurgitation, the jet diameter correlated well with the regurgitant stroke volume determined by a combined hemodynamic-angiographic method (r = 0.85, p less than 0.001). A jet diameter of 5.5 mm or more identified a regurgitant stroke volume of 60 ml or more with a sensitivity of 88%, specificity of 93%, and positive and negative predictive values of 94% and 87%, respectively. CONCLUSIONS: The regurgitant jet width at its origin measured by transesophageal Doppler color flow imaging provides a simple and useful method of measuring the severity of mitral regurgitation, and it may allow differentiation between mild and severe mitral regurgitation.
Tribouilloy et al. (1992) conducted a cross-sectional in mitral regurgitation (n=63). Transesophageal Doppler color flow imaging vs. Cardiac catheterization (angiographic grading) was evaluated on Correlation between jet diameter at its origin and angiographic grade of mitral regurgitation (r = 0.86, p=<0.001). A regurgitant jet diameter of ≥5.5 mm measured by transesophageal Doppler identified severe mitral regurgitation with 92% sensitivity and 92% specificity.