BACKGROUND: Recent studies have shown that many instrument and physiological factors limit the ability of color Doppler total jet area within the receiving chamber to predict the severity of valvular regurgitation. In contrast, the proximal or initial dimensions of the jet as it emerges from the orifice have been shown to increase directly with orifice size and to correlate well with the severity of aortic insufficiency. Only limited data, however, are available regarding the value of proximal jet size in mitral regurgitation, and it has not been examined in short-axis or transthoracic views. The purpose of the present study, therefore, was to evaluate the relation between proximal jet size and other measures of the severity of mitral regurgitation. METHODS AND RESULTS: In 49 patients, the anteroposterior height of the proximal jet as it emerges from the mitral valve was measured in the parasternal long-axis view; proximal jet width and area were measured in the short-axis view at the same level. Results were compared with regurgitant volume and fraction by pulsed Doppler subtraction of aortic and mitral flows in 47 patients without more than trace aortic insufficiency; with angiographic grade determined within 24 hours in 33 catheterized patients; and with angiographic regurgitant fraction in 13 patients who were in normal sinus rhythm and had no significant aortic and tricuspid insufficiency. Proximal jet height, width, and area correlated well with Doppler regurgitant volume and fraction (r = .86 to .95; SEE = 7.7 to 9.0 mL; 5.9% to 7.3%). Proximal jet size could also be used to distinguish angiographic grades of mitral regurgitation with minimal overlap (P < .0001) and correlated well with angiographic regurgitant fraction (r = .85 to .91; SEE = 4.1% to 5.1%). CONCLUSIONS: Proximal jet size correlates well with established measures of the severity of mitral regurgitation. It is conveniently available with transthoracic clinical scanning and should be useful in the routine evaluation of patients with mitral regurgitation.
BACKGROUND: Recent studies have shown that many instrument and physiological factors limit the ability of color Doppler total jet area within the receiving chamber to predict the severity of valvular regurgitation. In contrast, the proximal or initial dimensions of the jet as it emerges from the orifice have been shown to increase directly with orifice size and to correlate well with the severity of aortic insufficiency. Only limited data, however, are available regarding the value of proximal jet size in mitral regurgitation, and it has not been examined in short-axis or transthoracic views. The purpose of the present study, therefore, was to evaluate the relation between proximal jet size and other measures of the severity of mitral regurgitation. METHODS AND RESULTS: In 49 patients, the anteroposterior height of the proximal jet as it emerges from the mitral valve was measured in the parasternal long-axis view; proximal jet width and area were measured in the short-axis view at the same level. Results were compared with regurgitant volume and fraction by pulsed Doppler subtraction of aortic and mitral flows in 47 patients without more than trace aortic insufficiency; with angiographic grade determined within 24 hours in 33 catheterized patients; and with angiographic regurgitant fraction in 13 patients who were in normal sinus rhythm and had no significant aortic and tricuspid insufficiency. Proximal jet height, width, and area correlated well with Doppler regurgitant volume and fraction (r = .86 to .95; SEE = 7.7 to 9.0 mL; 5.9% to 7.3%). Proximal jet size could also be used to distinguish angiographic grades of mitral regurgitation with minimal overlap (P < .0001) and correlated well with angiographic regurgitant fraction (r = .85 to .91; SEE = 4.1% to 5.1%). CONCLUSIONS: Proximal jet size correlates well with established measures of the severity of mitral regurgitation. It is conveniently available with transthoracic clinical scanning and should be useful in the routine evaluation of patients with mitral regurgitation.
Authors: Francesca N Delling; Philimon Gona; Martin G Larson; Birgitta Lehman; Warren J Manning; Robert A Levine; Emelia J Benjamin; Ramachandran S Vasan Journal: J Am Soc Echocardiogr Date: 2013-10-24 Impact factor: 5.251
Authors: Tom C Nguyen; Akinobu Itoh; Carl J Carlhäll; Wolfgang Bothe; Tomasz A Timek; Daniel B Ennis; Robert A Oakes; David Liang; George T Daughters; Neil B Ingels; D Craig Miller Journal: J Thorac Cardiovasc Surg Date: 2008-09 Impact factor: 5.209
Authors: Catherine Szymanski; Robert A Levine; Christophe Tribouilloy; Hui Zheng; Mark D Handschumacher; Ahmed Tawakol; Judy Hung Journal: Am J Cardiol Date: 2011-09-21 Impact factor: 2.778
Authors: Judy Hung; Jorge Solis; J Luis Guerrero; Gavin J C Braithwaite; Orhun K Muratoglu; Miguel Chaput; Leticia Fernandez-Friera; Mark D Handschumacher; Van J Wedeen; Stuart Houser; Gus J Vlahakes; Robert A Levine Journal: Circulation Date: 2008-09-30 Impact factor: 29.690
Authors: Miguel Chaput; Mark D Handschumacher; Francois Tournoux; Lanqi Hua; J Luis Guerrero; Gus J Vlahakes; Robert A Levine Journal: Circulation Date: 2008-08-04 Impact factor: 29.690