Open AccessDoppler echocardiographic assessment of transmitral gradients and mitral valve area before and after mitral valve balloon dilatation
Author(s) -
Dev V.,
Singh L. S. K.,
Radhakrishnan S.,
Saxena A.,
Shrivastava S.
Publication year - 1989
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960121104
Subject(s) - medicine , cardiology , mitral valve , diastole , doppler echocardiography , cardiac catheterization , doppler effect , blood pressure , physics , astronomy
This is a comparative study of 60 sets of observations of mitral valve end‐diastolic gradient, mean diastolic gradient, and mitral valve area obtained by Doppler echocardiography and cardiac catheterization. The studies were performed in 28 patients, 16 of whom underwent mitral valve balloon valvuloplasty. These 16 patients had studies performed before, immediately after valvuloplasty, and one week later. Thus 28 studies were performed before or without valvuloplasty (Group I) and 32 after valvuloplasty (Group II). The time interval between Doppler echocardiography and cardiac catheterization was less than 24 hours in 44 studies and 24 to 72 hours in 16 studies. In Doppler echocardiography the gradients were obtained by simplified Bernoulli's equation and the mitral valve area by pressure half‐time method. There was excellent correlation between end‐diastolic gradients (r=0.96, p<0.001) and mean diastolic gradients (r=0.92, p<0.001) measured by the two techniques. A statistically significant correlation also existed in the mitral valve area values (r=0.53, p<0.005). On separate analysis Group I showed excellent correlation for all three variables (r values of 0.90, 0.87, and 0.82 for end‐diastolic gradients, mean‐diastolic gradients, and mitral valve area, respectively). Group II also showed excellent correlation of end‐diastolic gradients (r=0.80) and mean diastolic gradients (r=0.87), but poor correlation of the mitral valve areas (r=0.17; p=NS) by the two techniques. Doppler echocardiography can accurately measure transmitral gradients both before and after valvuloplasty. The mitral valve area derived by Doppler echocardiography using the pressure half‐time method was unreliable 1 to 7 days after mitral valvuloplasty in our experience. The presence of atrial fibrillation (n=8), mild aortic regurgitation (n=6), and mitral valve calcification (n=5) did not seem to alter the accuracy of Doppler echocardiography in assessing the severity of mitral stenosis.