+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

A new method for quantitation of mitral regurgitation based on color flow Doppler imaging of flow convergence proximal to regurgitant orifice



A new method for quantitation of mitral regurgitation based on color flow Doppler imaging of flow convergence proximal to regurgitant orifice



Circulation 84(4): 1481-1489



Background: Imaging of the flow convergence region (FCR) proximal to a regurgitant orifice has been shown to provide a method for quantifying the regurgitant flow rate. According to the continuity principle, the FCR is constituted by concentric hemispheric isovelocity surfaces centered at the orifice. The flow rate is constant across all isovelocity surfaces and equals the flow rate through the orifice. For any isovelocity surface the flow rate (Q) is given by: Q = 2 .pi.r2 vr, where 2.pi.r2 is the area of the hemisphere and Vr is the velocity at the radial distance (r) from the orifice. Methods and results: We studied 52 consecutive patients with mitral regurgitation (mean age, 49 years; are range, 21-66 years) verified by left ventricular angiography using color flow mapping. The FCR r was measured as the distance between the first aliasing limit - at a Nyquist limit obtained by zero-shifting the velocity cutoff to 38 cm/sec - and the regurgitant orifice. Seven patients without evidence of an FCR had only grade 1+ mitral regurgitation angiographically. There was a signifiant relation between the Doppler-derived maximal instantaneous regurgitant flow rate and the angiographic degree of mitral regurgitation in the other patients (rs = 0.91, p < 0.001). The regurgitant flow rate by Doppler also correlated with the angiographic regurgitant volume (r = 0.93, SEE = 123 ml/sec) in the 15 patients in normal sinus rhythm and without other regurgitant lesions in whom it could be measured. The correlation between regurgitant jet area within the left atrium and the angiographic grade was only fair (rs = 0.75, p < 0.001). Conclusions: Color flow Doppler provides new velocity information about the proximal FCR in patients with mitral regurgitation. According to the continuity principle, the maximal instantaneous regurgitant flow rate, obtained with the FCR method, may provide a quantitative estimate of the severity of mitral regurgitation, which is relatively independent of technical factors.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 006952145

Download citation: RISBibTeXText

PMID: 1914090

DOI: 10.1161/01.cir.84.4.1481


Related references

Color flow doppler quantitation of mitral regurgitation using an acceleration flow proximal to the orifice of a regurgitant jet. Circulation 80(4 Suppl. 2): II577, 1989

Color flow doppler quantitation of regurgitant flow rate using the flow convergence region proximal to the orifice of a regurgitant jet. Circulation 78(4 Part 2): II609, 1988

Color Doppler diagnosis of mechanical prosthetic mitral regurgitation: usefulness of the flow convergence region proximal to the regurgitant orifice. American Heart Journal 120(5): 1137-1142, 1990

A new method for quantification of regurgitant flow rate using color doppler flow imaging of the flow convergence region proximal to a discrete orifice a in vitro study. Circulation 83(2): 594-604, 1991

A new method for quantification of regurgitant flow rate using color Doppler flow imaging of the flow convergence region proximal to a discrete orifice. An in vitro study. Circulation 83(2): 594-604, 1991

Dynamic changes in mitral regurgitant orifice area A clinical study using color Doppler proximal flow convergence method. Circulation 86(4 Suppl. 1): I257, 1992

Comparison of direct planimetry of mitral valve regurgitation orifice area by three-dimensional transesophageal echocardiography to effective regurgitant orifice area obtained by proximal flow convergence method and vena contracta area determined by color Doppler echocardiography. American Journal of Cardiology 107(3): 452-458, 2011

Dynamics of regurgitant flow rate and orifice area in different forms of mitral regurgitation Physiological application of the proximal flow convergence method. Circulation 86(4 Suppl. 1): I805, 1992

Value of the proximal flow convergence method for quantification of the regurgitant volume in mitral regurgitation Influence of the mechanism of regurgitation, the imaging of the flow convergence region, and different calculation modalities. Zeitschrift für Kardiologie 93(12): 944-953, 2004

New method for accurate calculation of regurgitant flow rate based on analysis of Doppler color flow maps of the proximal flow field: Validation in a canine model of mitral regurgitation with initial application in patients. Journal of the American College of Cardiology 27(1): 161-172, 1996

Color flow Doppler determination of transmitral flow and orifice area in mitral stenosis: Experimental evaluation of the proximal flow-convergence method. American Heart Journal 129(1): 114-123, 1995

Effective regurgitant orifice area calculated by proximal flow convergence method for estimating severity of mitral regurgitation in patients. Journal of the American College of Cardiology 21(2 Suppl. A): 145A, 1993

Effective regurgitant orifice area by the color Doppler flow convergence method for evaluating the severity of chronic aortic regurgitation. An animal study. Circulation 93(3): 594-602, 1996

Quantitation of mitral regurgitation using a digital color Doppler centerline flow convergence method Validation in an animal model with prolapse type mitral regurgitation. Journal of the American College of Cardiology 21(2 Suppl. A): 75A, 1993

Accuracy of color Doppler velocity in the flow field proximal to a regurgitant orifice: Implications for color Doppler quantitation of valvular incompetence. Ultrasound in Medicine and Biology 22(5): 605-621, 1996