TY - JOUR
T1 - Day to day variability of doppler color flow jets in mitral regurgitation
AU - Grayburn, Paul A.
AU - Pryor, Susan L.
AU - Levine, Benjamin D.
AU - Klein, Mordecai N.
AU - Taylor, Anne L.
AU - Peters, Arvella
PY - 1989/10
Y1 - 1989/10
N2 - Doppler color flow mapping offers the potential to assess serial changes in mitral regurgitation associated with therapeutic interventions such as surgical valve repair or afterload reduction. However, the day to day variability of color flow jets in mitral regurgitation must be established to distinguish therapeutic responses from random variation. Therefore, 14 patients with mitral regurgitation were each studied on 5 sequential days by color flow velocity mapping. Instrument settings were kept constant for each patient, and no patient had a significant change in heart rate, blood pressure, left ventricular end-diastolic dimension or circumferential wall stress between studies. To assess day to day variability, the area of the Doppler color flow map was carefully measured in multiple views by an experienced echocardiographer. Mitral regurgitant jet area by color flow mapping tended to be greater from apical rather than parasternal views (5.6 ± 4.0 versus 2.9 ± 2.1 cm2, respectively, p < 0.03). The maximal jet area in any view ranged from 0.4 to 15.0 cm2 in individual subjects. Variability of maximal jet area within subjects was not statistically significant by repeated measures analysis of variance (F = 1.88, p = 0.13); however, the coefficient of variation was approximately 15%. Thus, a reduction in jet area of ≥30% would be needed to predict a therapeutic response at the 95% confidence level. These data have important implications regarding the use of color flow mapping to assess the efficacy of therapeutic interventions in mitral regurgitation.
AB - Doppler color flow mapping offers the potential to assess serial changes in mitral regurgitation associated with therapeutic interventions such as surgical valve repair or afterload reduction. However, the day to day variability of color flow jets in mitral regurgitation must be established to distinguish therapeutic responses from random variation. Therefore, 14 patients with mitral regurgitation were each studied on 5 sequential days by color flow velocity mapping. Instrument settings were kept constant for each patient, and no patient had a significant change in heart rate, blood pressure, left ventricular end-diastolic dimension or circumferential wall stress between studies. To assess day to day variability, the area of the Doppler color flow map was carefully measured in multiple views by an experienced echocardiographer. Mitral regurgitant jet area by color flow mapping tended to be greater from apical rather than parasternal views (5.6 ± 4.0 versus 2.9 ± 2.1 cm2, respectively, p < 0.03). The maximal jet area in any view ranged from 0.4 to 15.0 cm2 in individual subjects. Variability of maximal jet area within subjects was not statistically significant by repeated measures analysis of variance (F = 1.88, p = 0.13); however, the coefficient of variation was approximately 15%. Thus, a reduction in jet area of ≥30% would be needed to predict a therapeutic response at the 95% confidence level. These data have important implications regarding the use of color flow mapping to assess the efficacy of therapeutic interventions in mitral regurgitation.
UR - http://www.scopus.com/inward/record.url?scp=0024417701&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0024417701&partnerID=8YFLogxK
U2 - 10.1016/0735-1097(89)90469-5
DO - 10.1016/0735-1097(89)90469-5
M3 - Article
C2 - 2794282
AN - SCOPUS:0024417701
SN - 0735-1097
VL - 14
SP - 936
EP - 940
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 4
ER -