Abstract: 1016-173; Sunday, March 7, 1999; Morial
Convention Center, Hall F; Noon1:00 p.m.; Noon2:00 p.m.
Session:
Mitral Valve Disease
Quantitative Analysis of Mitral Regurgitation Jet Eccentricity by Color Flow
Doppler Identifies Patients With Flail Leaflet
Paolo C. Colombo, Rex
H. Wu, Stanislav Weiner, Massimo Marinaccio,
Jamshid Shirani, Michele Nanna
Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NYUSA
Background: Early surgical intervention improves the outcome
of patients (pts) with mitral regurgitation (MR) secondary to flail leaflet
(FL). However, accurate definition of mitral FL requires detailed anatomical
screening by transesophageal echocardiography (TEE). The value of MR jet
characteristics alone has not been established. We hypothesized that (see
figure), the angle (1) between the axis of the proximal portion of color flow
Doppler MR jet (2) and the plane of mitral annulus (3), as measured
quantitatively by a customized computer software, would identify patients with
mitral FL
Methods: We studied 41 pts (mean age 63 ± 6 yrs) with mitral
FI anatomically confirmed by TEE or surgery and a control group of 41 pts (mean
age 67 ± 15 yrs) with at least moderate MR, but no FL. Selected digitized frames
from TEE or transthoracic echocardiography (TTE) studies were used for
analysis.
Results: In pts with mitral FL, the mean angle formed
by the axis of MR jet and the plane of mitral annulus was 33° ± 12° and 27° ±
17° when measured by TTE and TEE respectively (p < 0.001). In controls
the mean angle was 59° ± 16° and 63° ± 19° by TTE and TEE respectively (p <
0.001). Based on Reiceiver Operating Characteristic (ROC) analysis the optimal
cutoff jet angle value for diagnosing mitral FL was < 40° by TTE and <47°
by TEE (sensitivity: 85% and 90%, specificity: 91% and 81%, positive likelihood
ratio: 9.84 and 4.6, negative likelihood ratio: 0.17 and 0.12 by TTE and TEE
respectively).
Conclusion: Quantitative analysis of MR jet
eccentricity by Color Flow Doppler is useful in identifying patients with mitral
FL.
Cardiomyopathies, dilated
Mitral
regurgitation
Valvular disease
Updated January 31,
1999
