A new echocardiographic index for assessing left ventricular function and mechanism of mitral regurgitation and its relation to other echocardiographic indices.
OBJECTIVE
Mitral regurgitation (MR) is a progressive disease of the mitral valve, which can be primary or functional. The assessment of left ventricular function in MR is still troublesome. In this study, we evaluated the validity of a new parameter, total dt, in patients with MR.


METHODS
Forty patients with severe MR constituted the study group. According to the transesophageal echocardiographic evaluation, the patients were dichotomized into two groups: (1) Primary MR; n = 21, (2) Functional MR; n = 19. The total dt was defined as the sum of time intervals from 1 msto 3 ms (positive dt) and from 3 ms to 1 ms (negative dt) on the CW Doppler recording of MR jet. It was compared to other indices of left ventricular function and left ventricular geometry, including ejection fraction, fractional shortening, myocardial performance index, coaptation distance, left ventricular volume and diameter, sphericity index, and parameters of diastolic function.


RESULTS
The total dt correlated with myocardial performance index, coaptation distance, and sphericity index. It could differentiate between primary and functional MR with an area under curve of 0.878, followed by myocardial performance index with 0.860. The total dt > 104 ms was 79% sensitive and 81% specific for discrimination.


CONCLUSIONS
The total dt is useful for assessing left ventricular function and also for differentiating primary MR from functional MR.
Sag
Cemal
C
Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey. esag@gata.edu.tr
Uzun
Mehmet
M
Bolcal
Cengiz
C
Yokusoglu
Mehmet
M
Kucukarslan
Nezihi
N
Koz
Cem
C
Baysan
Oben
O
Ozkan
Mustafa
M
Karaeren
Hayrettin
H
Genç
Celal
C
Isik
Ersoy
E
D019540:Area Under Curve; D001794:Blood Pressure; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology