Fehmi H, Sag C, Kirilmaz A, Altun T, Demirkan D.
Assessment of minimal mitral regurgitation: comparative study with Doppler echocardiography and ventriculography.
J Pak Med Assoc Jan ;47(12):292-5.

This study was designed to assess color Doppler echocardiographic parameters in subjects with minimal mitral regurgitation (MR) in an otherwise normal heart. Study cases were selected during a five month period from 2500 young males with an echocardiographic indication on the basis of subjects complaints and physical examination. Left ventriculography was performed and subjects were dichotomized into group-1 (n = 30) if there was angiographically MR and into group-2 (n = 30) if they were 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 (0.710 +/- 0.244 vs 0.430 +/- 0.268, respectively, p < 0.001), 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 log axis (180 +/- 77 vs 120 +/- 69, respectively, p = 0.003), 4) the regurgitant jet area in parasternal long axis (0.813 +/- 0.651 vs 0.411 +/- 0.431, respectively, p = 0.007). The maximal duration of MR/mean systolic time interval > or = 0.6, regurgitant jet area > or = 0.4 cm2, and regurgitant peak velocity > or = 130 cm/sec. in parasternal long axis dichotomize the cases into true with a predictive value of 76%, 67% and 63%, respectively.

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