Comparison of mitral valve area by pressure half-time and proximal isovelocity surface area method in patients with mitral stenosis: effect of net atrioventricular compliance.
OBJECTIVE
The aim of this study was to test the hypothesis that, unlike calculation of the mitral valve area (MVA) with the pressure half-time method (PHT), the proximal isovelocity surface area method (PISA) is not affected by changes in net atrioventricular compliance (C(n)).


RESULTS
We studied 51 patients with mitral stenosis (MS) from two centres. MVA was assessed with the PISA (MVA(PISA)), PHT (MVA(PHT)), and planimetry (MVA(PLN), serving as the gold standard) method. C(n) was calculated with a previously validated equation using 2D echocardiography. MVA(PISA) closely correlated with MVA(PLN) (r = 0.96, P < 0.0001), while MVA(PHT) and MVA(PLN) showed a weaker but still good correlation (r = 0.69, P < 0.0001). The correlation between MVA(PHT) and MVA(PLN) for patients with C(n) between 4 and 6 mL/mmHg (considered to be normal) was excellent (r = 0.93, P < 0.0001), but that for patients with C(n) of less than 4 or more than 6 mL/mmHg was not as good (r = 0.64, P < 0.0001). Importantly, a significant inverse correlation was detected between the percentage difference among MVA(PHT), MVA(PLN), and C(n) (r = -0.77, P < 0.0001), but the line of fit was nearly flat for the percentage difference among MVA(PISA), MVA(PLN), and C(n) (r = 0.1, P = 0.388).


CONCLUSIONS
MVA calculated with both the PISA and PHT methods correlated well with MVA calculated with the planimetry method. However, the PISA rather than PHT is recommended for patients with MS and extreme C(n) values because PISA, unlike PHT, is not affected by changes in C(n).
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Japan.
Alaa Mabrouk
AM
Salem Omar
Hidekazu
H
Tanaka
Tarek Khairy
TK
AbdelDayem
Ayman S
AS
Sadek
Halah
H
Raslaan
Ashraf
A
Al-Sherbiny
Kohei
K
Yamawaki
Keiko
K
Ryo
Yuko
Y
Fukuda
Kazuko
K
Norisada
Kazuhiro
K
Tatsumi
Tetsuari
T
Onishi
Kensuke
K
Matsumoto
Hiroya
H
Kawai
Ken-ichi
K
Hirata
D001783:Blood Flow Velocity; D004452:Echocardiography / Q000379:methods*; D018618:Echocardiography, Doppler, Color / Q000379:methods; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D012720:Severity of Illness Index