[A pulsed Doppler transesophageal echocardiographic study of pulmonary venous flow in mitral regurgitation jets in the parietal direction].
OBJECTIVE
Transesophageal echocardiographic analysis of the degree of severity of mitral regurgitation eccentric wall jets by color Doppler and pulsed Doppler interrogation of the pulmonary venous flow.


METHODS
Transesophageal echocardiographic prospective study.


METHODS
consecutive out and in patients referred to the Echocardiographic Laboratory of Gregorio Marañon General Hospital, Madrid, Spain.


METHODS
We studied 90 consecutive patients with the clinical and echocardiographic diagnosis of valvular mitral regurgitation. In each patient through pulsed Doppler transesophageal echocardiographic technique, we measured the peak velocities and areas of systolic forward flow and systolic reversed flow of the left superior pulmonary vein. By pulsed color Doppler transesophageal echocardiographic technique, we calculated total area, severity and spatial direction of the mitral regurgitant jet.


RESULTS
There were 80% (72/90) of patients included in the JC group and 20% (18/90) in the JP group. The color Doppler maximal area in the JC group was 484 +/- 118 mm2 and 445 +/- 79 mm2 (p = NS) in the JP group. Mild mitral regurgitation was present in 32% (23/72) and 55% (10/18) of the patients in the JC and JP groups (p < 0.01) respectively. Severe mitral regurgitation was present in 29% (21/72) and 0% (0/18) of the same groups (p < 0.0001). Peak velocity of pulsed Doppler pulmonary venous systolic forward flow in JC and JP groups was 47 +/- 7 cm/sec and 29 +/- 8 cm/sec respectively (p < 0.01). Maximal area of pulmonary venous flow wave in JC and JP groups was 1215 +/- 140 mm2 and 568 +/- 176 mm2 (p < 0.001) respectively. Peak velocity of reversed systolic pulmonary venous flow in JC and JP groups was 28 +/- 10 cm/sec and 46 +/- 8 cm/sec (p < 0.01) respectively. Maximal area of reversed pulmonary venous flow of JC and JP groups was 124 +/- 30 mm2 and 389 +/- 40 mm2 (p < 0.001) respectively.


CONCLUSIONS
Color Doppler echocardiographic evaluation of mitral regurgitation wall jets, is not an exact method to quantify their degree of severity. In the assessment of extreme eccentric mitral regurgitation jets that interact with the atrial wall, the color Doppler quantification criteria is not sufficient. In these cases of mitral regurgitation wall jets, pulmonary venous pulsed Doppler flow criteria can be useful.
Azevedo
J
J
Laboratório de Ecocardiografia, Hospital Gregorio Marañon, Madrid, Espanha.
Garcia-Gernandez
M A
MA
SanRoman
D
D
Torrecilla
E
E
Delcan
J L
JL
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D004947:Esophagus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011446:Prospective Studies; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000000981:diagnostic imaging*
Estudo Doppler pulsado do fluxo venoso pulmonar por ecocardiografia transesofágica em jactos de regurgitação mitral de direcção parietal.