title: Quantification of mitral regurgitation by the proximal flow convergence method--comparison of transthoracic and transesophageal echocardiography.
abstract: BACKGROUND
  No dataexist to indicate whether transthoracic (TTE) and transesophageal echocardiography (TEE) are of comparable value for the detection and quantification of mitral regurgitation using the proximal flow convergence method.
  
  
  OBJECTIVE
  The study was performed to compare the value of TTE and TEE for the detection and quantification of mitral regurgitation using this method.
  
  
  METHODS
  The study included 57 patients with and 11 patients without mitral regurgitation. In all patients, the proximal flow convergence region was imaged by transthoracic and transesophageal color Doppler echocardiography, and proximal isovelocity surface area radii were determined. In 19 patients, monoplane TEE and in 49 patients multiplane TEE was performed. Thirty-one patients with mitral regurgitation underwent cardiac catheterization.
  
  
  RESULTS
  Both methods had a comparable sensitivity for the detection of mitral regurgitation. Proximal isovelocity surface area radii derived from TTE and TEE agreed moderately (mean difference -0.5 +/- 1.3 mm). TTE and TEE correlated significantly with the angiographic grade (rank correlation coefficients 0.83 and 0.81), and both differentiated mild to moderate from severe mitral regurgitation with an accuracy of 90%. Regurgitant volumes derived from both echocardiographic techniques and cardiac catheterization correlated moderately (correlation coefficients between 0.67 and 0.81).
  
  
  CONCLUSIONS
  TTE and TEE were of comparable value for the detection and quantification of mitral regurgitation using the proximal flow convergence method.
authors.affiliation: Department of Internal Medicine, University of Ulm, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Grossmann
authors.forename: Jochen
authors.initials: J
authors.lastname: Wöhrle
authors.forename: Matthias
authors.initials: M
authors.lastname: Kochs
authors.forename: Martin
authors.initials: M
authors.lastname: Giesler
authors.forename: Vintenz
authors.initials: V
authors.lastname: Hombach
authors.forename: Martin
authors.initials: M
authors.lastname: Höher
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000145:classification / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity