Pulsed Doppler patterns of left atrial flow in mitral regurgitation.

A prospective pulsed Doppler study of 55 patients was undertaken to detect and quantitate mitral regurgitation. Systolic left atrial flow dispersion indicated mitral regurgitation. Doppler study was feasible in nearly 95% of patients. Sensitivity, specificity and predictive accuracy were 89%, 84% and 88%, respectively. Three methods were used to quantitate mitral regurgitation: (1) maximal depth level of systolic left atrial flow, (2) left atrial flow patterns immediately behind the mitral valve closure line (I, protosystolic; II, gradual decrease in intensity of left atrial flow signal throughout systole; and III, broad flow dispersion occupying all systole); and (3) a score system that combined these 2 methods. Results showed that flow patterns behind the mitral valve closure line correlate with angiographic assessment of mitral regurgitation. This provided the simplest and most practical method of determining the severity of mitral regurgitation.