Color Doppler regurgitant jet area for evaluating eccenteric mitral regurgitation

An animal study with quantified mitral regurgitation

Takahiro Shiota, Michael Jones, Dag Teien, Izumi Yamada, Arnaldo Passafini, Ole Knudson, David Sahn

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objectives. The purpose of the present study was to rigorously evaluate the accuracy of the color Doppler jet area planimetry method for quantifying chronic mitral regurgitation. Background. Although the color Doppler jet area has been widely used clinically for evaluating the severity of mitral regurgitation, there have been no studies comparing the color jet area with a strictly quantifiable reference standard for determining regurgitant volume. Methods. In six sheep with surgically produced chronic mitral regurgitation, 24 hemodynamically different states were obtained. Maximal color Doppler jet area for each state was obtained with a Vingmed 750. Image data were directly transferred in digital format to a microcomputer. Mitral regurgitation was quantified by the peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions determined using mitral and aortic electromagnetic flow probes. Results. Mean regurgitant volumes varied from 0.19 to 2.4 liters/ min (mean [±SD] 1.2 ± 0.59), regurgitant stroke volumes from 1.8 to 29 ml/beat (mean 11 ± 6.2), peak regurgitant volumes from 1.0 to 8.1 liters/min (mean 3.5 ± 2.1) and regurgitant fractions from 8.0% to 54% (mean 29 ± 12%). Twenty-two of 24 jets were eccentric. Simple linear regression analysis between maximal color jet areas and peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions showed correlation, with r = 0.68 (SEE 0.64 cm2), r = 0.63 (SEE 0.67 cm2), r = 0.63 (SEE 0.67 cm2) and r = 0.58 (SEE 0.71 cm2), respectively. Univariate regression comparing regurgitant jet area with cardiac output, stroke volume, systolic left ventricular pressure, pressure gradient, left ventricular/ left atrial pressure gradient, left atrial mean pressure, left atrial v wave pressure, systemic vascular resistance and maximal jet velocity showed poor correlation (0.08 <r <0.53, SEE > 0.76 cm2). Conclusions. This study demonstrates that color Doppler jet area has limited use for evaluating the severity of mitral regurgitation with eccentric jets.

Original languageEnglish (US)
Pages (from-to)813-819
Number of pages7
JournalJournal of the American College of Cardiology
Volume24
Issue number3
DOIs
StatePublished - 1994

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Mitral Valve Insufficiency
Color
Stroke Volume
Atrial Pressure
Pressure
Electromagnetic Phenomena
Microcomputers
Ventricular Pressure
Cardiac Output
Vascular Resistance
Linear Models
Sheep
Regression Analysis

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Color Doppler regurgitant jet area for evaluating eccenteric mitral regurgitation : An animal study with quantified mitral regurgitation. / Shiota, Takahiro; Jones, Michael; Teien, Dag; Yamada, Izumi; Passafini, Arnaldo; Knudson, Ole; Sahn, David.

In: Journal of the American College of Cardiology, Vol. 24, No. 3, 1994, p. 813-819.

Research output: Contribution to journalArticle

Shiota, Takahiro ; Jones, Michael ; Teien, Dag ; Yamada, Izumi ; Passafini, Arnaldo ; Knudson, Ole ; Sahn, David. / Color Doppler regurgitant jet area for evaluating eccenteric mitral regurgitation : An animal study with quantified mitral regurgitation. In: Journal of the American College of Cardiology. 1994 ; Vol. 24, No. 3. pp. 813-819.
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title = "Color Doppler regurgitant jet area for evaluating eccenteric mitral regurgitation: An animal study with quantified mitral regurgitation",
abstract = "Objectives. The purpose of the present study was to rigorously evaluate the accuracy of the color Doppler jet area planimetry method for quantifying chronic mitral regurgitation. Background. Although the color Doppler jet area has been widely used clinically for evaluating the severity of mitral regurgitation, there have been no studies comparing the color jet area with a strictly quantifiable reference standard for determining regurgitant volume. Methods. In six sheep with surgically produced chronic mitral regurgitation, 24 hemodynamically different states were obtained. Maximal color Doppler jet area for each state was obtained with a Vingmed 750. Image data were directly transferred in digital format to a microcomputer. Mitral regurgitation was quantified by the peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions determined using mitral and aortic electromagnetic flow probes. Results. Mean regurgitant volumes varied from 0.19 to 2.4 liters/ min (mean [±SD] 1.2 ± 0.59), regurgitant stroke volumes from 1.8 to 29 ml/beat (mean 11 ± 6.2), peak regurgitant volumes from 1.0 to 8.1 liters/min (mean 3.5 ± 2.1) and regurgitant fractions from 8.0{\%} to 54{\%} (mean 29 ± 12{\%}). Twenty-two of 24 jets were eccentric. Simple linear regression analysis between maximal color jet areas and peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions showed correlation, with r = 0.68 (SEE 0.64 cm2), r = 0.63 (SEE 0.67 cm2), r = 0.63 (SEE 0.67 cm2) and r = 0.58 (SEE 0.71 cm2), respectively. Univariate regression comparing regurgitant jet area with cardiac output, stroke volume, systolic left ventricular pressure, pressure gradient, left ventricular/ left atrial pressure gradient, left atrial mean pressure, left atrial v wave pressure, systemic vascular resistance and maximal jet velocity showed poor correlation (0.08 0.76 cm2). Conclusions. This study demonstrates that color Doppler jet area has limited use for evaluating the severity of mitral regurgitation with eccentric jets.",
author = "Takahiro Shiota and Michael Jones and Dag Teien and Izumi Yamada and Arnaldo Passafini and Ole Knudson and David Sahn",
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T1 - Color Doppler regurgitant jet area for evaluating eccenteric mitral regurgitation

T2 - An animal study with quantified mitral regurgitation

AU - Shiota, Takahiro

AU - Jones, Michael

AU - Teien, Dag

AU - Yamada, Izumi

AU - Passafini, Arnaldo

AU - Knudson, Ole

AU - Sahn, David

PY - 1994

Y1 - 1994

N2 - Objectives. The purpose of the present study was to rigorously evaluate the accuracy of the color Doppler jet area planimetry method for quantifying chronic mitral regurgitation. Background. Although the color Doppler jet area has been widely used clinically for evaluating the severity of mitral regurgitation, there have been no studies comparing the color jet area with a strictly quantifiable reference standard for determining regurgitant volume. Methods. In six sheep with surgically produced chronic mitral regurgitation, 24 hemodynamically different states were obtained. Maximal color Doppler jet area for each state was obtained with a Vingmed 750. Image data were directly transferred in digital format to a microcomputer. Mitral regurgitation was quantified by the peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions determined using mitral and aortic electromagnetic flow probes. Results. Mean regurgitant volumes varied from 0.19 to 2.4 liters/ min (mean [±SD] 1.2 ± 0.59), regurgitant stroke volumes from 1.8 to 29 ml/beat (mean 11 ± 6.2), peak regurgitant volumes from 1.0 to 8.1 liters/min (mean 3.5 ± 2.1) and regurgitant fractions from 8.0% to 54% (mean 29 ± 12%). Twenty-two of 24 jets were eccentric. Simple linear regression analysis between maximal color jet areas and peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions showed correlation, with r = 0.68 (SEE 0.64 cm2), r = 0.63 (SEE 0.67 cm2), r = 0.63 (SEE 0.67 cm2) and r = 0.58 (SEE 0.71 cm2), respectively. Univariate regression comparing regurgitant jet area with cardiac output, stroke volume, systolic left ventricular pressure, pressure gradient, left ventricular/ left atrial pressure gradient, left atrial mean pressure, left atrial v wave pressure, systemic vascular resistance and maximal jet velocity showed poor correlation (0.08 0.76 cm2). Conclusions. This study demonstrates that color Doppler jet area has limited use for evaluating the severity of mitral regurgitation with eccentric jets.

AB - Objectives. The purpose of the present study was to rigorously evaluate the accuracy of the color Doppler jet area planimetry method for quantifying chronic mitral regurgitation. Background. Although the color Doppler jet area has been widely used clinically for evaluating the severity of mitral regurgitation, there have been no studies comparing the color jet area with a strictly quantifiable reference standard for determining regurgitant volume. Methods. In six sheep with surgically produced chronic mitral regurgitation, 24 hemodynamically different states were obtained. Maximal color Doppler jet area for each state was obtained with a Vingmed 750. Image data were directly transferred in digital format to a microcomputer. Mitral regurgitation was quantified by the peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions determined using mitral and aortic electromagnetic flow probes. Results. Mean regurgitant volumes varied from 0.19 to 2.4 liters/ min (mean [±SD] 1.2 ± 0.59), regurgitant stroke volumes from 1.8 to 29 ml/beat (mean 11 ± 6.2), peak regurgitant volumes from 1.0 to 8.1 liters/min (mean 3.5 ± 2.1) and regurgitant fractions from 8.0% to 54% (mean 29 ± 12%). Twenty-two of 24 jets were eccentric. Simple linear regression analysis between maximal color jet areas and peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions showed correlation, with r = 0.68 (SEE 0.64 cm2), r = 0.63 (SEE 0.67 cm2), r = 0.63 (SEE 0.67 cm2) and r = 0.58 (SEE 0.71 cm2), respectively. Univariate regression comparing regurgitant jet area with cardiac output, stroke volume, systolic left ventricular pressure, pressure gradient, left ventricular/ left atrial pressure gradient, left atrial mean pressure, left atrial v wave pressure, systemic vascular resistance and maximal jet velocity showed poor correlation (0.08 0.76 cm2). Conclusions. This study demonstrates that color Doppler jet area has limited use for evaluating the severity of mitral regurgitation with eccentric jets.

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