Assessment of Doppler Echocardiography in Minimal Mitral Regurgitation: A Comparative Study with Ventriculography

This study is designed to assess color Doppler echocardiographic parameters in subjects with minimal mitral regurgitation (MR) in otherwise normal heart. Study cases have been selected during a five-month period among 2500 young male with an echocardiographic indication on the basis of subjects' complaints and upon physical examination. Left ventriculography was performed and subjects were dichotomized into group-I (n=30) if there was angiographically MR, and into group-2 (n=30) if they are intact. Patients in group- 1 were described as to have "true MR" and MR flow in group-2 was named "physiological". Doppler echocardiographic variables of true and physiological MR are compared to each other. The following echocardiographic variables were significantly different between group-1 and group-2: 1) the ratio of the max. duration of MR/mean systolic interval in parasternal long axis (0.7 10±0.244 vs 0.430±0.268, respectively, p<0.0001), 2) the ratio of the maximum duration of MR/mean systolic interval in apical four chamber view (0.550±0.361 vs 0.317±0.272 respectively, p=0.007), 3) the peak velocity of the regurgitant flow in parasternal long axis (180±77 vs 120±69 cm/sec., respectively, p=0.003), 4) the regurgitant jet area in parasternal long axis (0.813±0.651 vs 0.411±0.431 cm2, respectively, p=0.007). The maximal duration of MR/mean systolic time interval ≥0.6, regurgitant jet area ≥0.4cm2 , and regurgitant peak velocity ≥130 cm/sec. in parasternal long axis dichotomize the cases into true MR with a predictive value of 76%, 67%, and 63%, respectively.