Evaluation of mitral regurgitation using a digitally determined color Doppler flow convergence 'centerline' acceleration method

Studies in an animal model with quantified mitral regurgitation

Takahiro Shiota, Michael Jones, Dag E. Teien, Izumi Yamada, Arnaldo Passafini, Shuping Ge, Robin Shandas, Lilliam M. Valdes-Cruz, David Sahn

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: The imaging and measurement of the proximal flow convergence region in the left ventricle have been reported to be useful for identifying the site of mitral regurgitation (MR) and for evaluating its severity. However, the application of this method has not gained general acceptance. There have been few in vivo studies with quantified reference standards for determining regurgitant volume, and those that have been reported used spectral Doppler standards and/or nonsimultaneously performed contrast ventriculography. The purpose of the present study was to evaluate the proximal flow convergence centerline velocity-distance profile method applied to chronic MR resulting from flail mitral leaflets in an animal model in which regurgitant flow rates and regurgitant volumes were determined simultaneously with electromagnetic flow probes and flowmeters. Methods and Results: In six sheep, a total of 18 hemodynamically different states were obtained when the animals were restudied 6 months after surgical induction of MR produced by severing chordae tendineae to the anterior (three sheep) or posterior (three sheep) mitral leaflet. Echocardiographic studies with a Vingmed 750 were performed to obtain complete proximal axial flow acceleration velocity-distance profiles for each hemodynamic state. The color Doppler velocity data were directly transferred in digital format from the ultrasound instrumentation to a microcomputer. The severity of MR was assessed by the magnitude of the mitral regurgitant fraction determined using both mitral and aortic electromagnetic flow probes balanced against each other to yield regurgitant volume. MR was classified as grade I when the regurgitant fraction was 35%. Thus, of the 18 hemodynamic states, 4 (from two sheep) were grade I, 7 (from five sheep) were grade II, and 7 (from three sheep) were grade III to IV. All of the velocity-distance acceleration curves showed organized acceleration fields with highly significant correlations using multiplicative regression fits (y=a · x-b, r=.90 to .99, all P0.5 m/s at distances from the orifice >0.6 cm; the profiles for grade I regurgitation resided in a domain encompassed by velocities

Original languageEnglish (US)
Pages (from-to)2879-2887
Number of pages9
JournalCirculation
Volume89
Issue number6
StatePublished - Jun 1994

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Mitral Valve Insufficiency
Sheep
Animal Models
Color
Electromagnetic Phenomena
Hemodynamics
Chordae Tendineae
Flowmeters
Microcomputers
Heart Ventricles

Keywords

  • echocardiography
  • flow
  • regurgitation
  • valves

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of mitral regurgitation using a digitally determined color Doppler flow convergence 'centerline' acceleration method : Studies in an animal model with quantified mitral regurgitation. / Shiota, Takahiro; Jones, Michael; Teien, Dag E.; Yamada, Izumi; Passafini, Arnaldo; Ge, Shuping; Shandas, Robin; Valdes-Cruz, Lilliam M.; Sahn, David.

In: Circulation, Vol. 89, No. 6, 06.1994, p. 2879-2887.

Research output: Contribution to journalArticle

Shiota, T, Jones, M, Teien, DE, Yamada, I, Passafini, A, Ge, S, Shandas, R, Valdes-Cruz, LM & Sahn, D 1994, 'Evaluation of mitral regurgitation using a digitally determined color Doppler flow convergence 'centerline' acceleration method: Studies in an animal model with quantified mitral regurgitation', Circulation, vol. 89, no. 6, pp. 2879-2887.
Shiota, Takahiro ; Jones, Michael ; Teien, Dag E. ; Yamada, Izumi ; Passafini, Arnaldo ; Ge, Shuping ; Shandas, Robin ; Valdes-Cruz, Lilliam M. ; Sahn, David. / Evaluation of mitral regurgitation using a digitally determined color Doppler flow convergence 'centerline' acceleration method : Studies in an animal model with quantified mitral regurgitation. In: Circulation. 1994 ; Vol. 89, No. 6. pp. 2879-2887.
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