Mitral to aortic velocity-time integral ratio. A non-geometric pulsed-Doppler regurgitant index in isolated pure mitral regurgitation.

To determine the clinical value of a simple and non-geometric pulsed Doppler regurgitant index, namely the mitral to aortic velocity-time integral (VTI) ratio in the semiquantitative assessment of severity of isolated pure mitral regurgitation (MR), 109 patients with isolated pure MR and sinus rhythm prospectively underwent Doppler echocardiography within 48 h of cardiac catheterization. The eccentricity of regurgitant jets was assessed by Doppler colour flow imaging and the mitral and aortic VTI and its ratio were derived from the pulsed Doppler method. Angiographic grade of MR was evaluated in all patients with MR, but haemodynamic regurgitant fraction was determined in only 91 patients. Fifty patients in sinus rhythm and without valvular disease served as controls. In the control group, the mitral VTI (16.2 +/- 2.5 cm) was lower than the aortic VTI (20.6 +/- 2.8 cm) (P < 0.001), resulting in a mitral to aortic VTI ratio of 0.79 +/- 0.08. In patients with MR, the mitral VTI was significantly greater than the aortic VTI (23.1 +/- 6.8 vs 16.9 +/- 4.7 cm, P < 0.001). There was a close relationship between the mitral to aortic VTI ratio and the angiographic grading of MR (n = 109, r = 0.74, P < 0.001). A ratio > or = 1.3 classified patients with severe MR (grade III or IV) with a sensitivity of 87%, a specificity of 91%, and positive and negative predictive values of 93% and 84%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)