Value and limitations of color Doppler flow mapping in the detection and semiquantification of valvular regurgitation

  • Junichi Yoshikawa
  • Kiyoshi Yoshida
  • Takashi Akasaka
  • Masahiro Shakudo
  • Hiroshi Kato
Article

Summary

We compared color Doppler flow mapping data to angiographic data in 294 patients with suspected valvular regurgitation. Thirty-one patients had rheumatic mitral regurgitation and 37 had mitral regurgitation due to mitral valve prolapse by angiography. Ten patients had no angiographic regurgitation (4 rheumatic, 6 prolapse). The remaining patients included 86 with suspected aortic regurgitation and 130 with suspected tricuspid regurgitation. Angiographically 74 had aortic regurgitation and 111 tricuspid regurgitation. The maximum size of regurgitant jets was evaluated in each patient by color flow mapping. The width of the jets was also taken into consideration. In 29 of the 31 with rheumatic regurgitation and 67 of the 74 with aortic regurgitation by angiography, abnormal regurgitant signals were detected by color flow mapping. In both rheumatic mitral regurgitation and aortic regurgitation, color Doppler estimation of the jets correlated well with angiographic grading. The regurgitant jets in these regurgitation were not eccentric. In the 37 with mitral regurgitation in mitral valve prolapse by left ventriculography, abnormal jets were detected in 35 by color flow mapping. However, the regurgitant jets were eccentric and color Doppler estimation of the jets correlated poorly with angiographic grading. In patients with tricuspid regurgitation, color Doppler grading of regurgitation correlated poorly with right ventriculographic grading. A color Doppler underestimation was observed in 48%. In conclusion, color Doppler flow mapping is useful in the noninvasive detection and semiquantification of rheumatic mitral regurgitation and aortic regurgitation having non-eccentric jets, although this technique often underestimates the severity of regurgitation in mitral valve prolapse.

Keywords

Color Mitral Regurgitation Maximum Size Mapping Data Aortic Regurgitation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Abbasi AS, Allen MW, DeCristofaro D, et al.: Detection and estimation of the degree of mitral regurgitation by ranged gated pulsed Doppler echocardiography. Circulation 61: 143, 1980PubMedGoogle Scholar
  2. 2.
    Quinones MA, Young JB, Waggoner AD, et al.: Assessment of pulsed Doppler echocardiography in detection and quantification of aortic and mitral regurgitation. Br Heart J 44: 612, 1980PubMedGoogle Scholar
  3. 3.
    Blanchard D, Diebold B, Peronneau P, et al.: Non-invasive diagnosis of mitral regurgitation by Doppler echocardigraphy. Br Heart J 45: 859, 1981Google Scholar
  4. 4.
    Diebold B, Theroux P, Bourassa MG, et al.: Non-invasive pulsed Doppler study of mitral stenosis and mitral regurgitation: Preliminary study. Br Heart J 42: 168, 1979PubMedGoogle Scholar
  5. 5.
    Patel AK, Rowe GG, Thomsen JH, et al.: Detection and estimation of rheumatic mitral regurgitation in the presence of mitral stenosis by pulsed Doppler echocardiography. Am J Cardiol 51: 986, 1983PubMedGoogle Scholar
  6. 6.
    Panidis IP, McAllister M, Ross J, et al.: Prevalence and severity of mitral regurgitation in the mitral prolapse syndrome: A Doppler echocardiographic study of 80 patients. J Am Coll Cardiol 7: 975, 1986PubMedGoogle Scholar
  7. 7.
    Miyatake K, Okamoto M, Kinoshita N, et al.: Evaluation of tricuspid regurgitation by pulsed Doppler and two-dimensional echocardiography. Circulation 66: 777, 1982PubMedGoogle Scholar
  8. 8.
    Namekawa K, Kasai C, Tsukamoto M, et al.: Real-time blood flow imaging system utilizing auto-correlation techniques. In: Lerski RA, Morley P (eds) Ultrasound '82. Pergamon Press, Oxford, England, 1983, p 203Google Scholar
  9. 9.
    Miyatake K, Okamoto M, Kinoshita N, et al.: Clinical applications of a new type of real-time two-dimensional Doppler flow imaging system. Am J Cardiol 54: 857, 1984PubMedGoogle Scholar
  10. 10.
    Omoto R, Yokote Y, Takamoto S, et al.: The development of real-time two-dimensional Doppler echocardiography and its clinical significance in acquired valvular diseases. With specific reference to the evaluation of valvular regurgitation. Jpn Heart J 25: 325, 1984PubMedGoogle Scholar
  11. 11.
    Croft CH, Lipscomb K, Mathis K, et al.: Limitations of quantitative angiographic grading in aortic or mitral regurgitation. Am J Cardiol 53: 1593, 1984Google Scholar
  12. 12.
    Grossman W, Dexter L: Profiles in valvular heart disease. In: Grossman W (ed) Cardiac Catheterization and Angiography. Lea & Febiger, Philadelphia, 1980, p 305Google Scholar
  13. 13.
    Cairns KB, Kloster FE, Bristow JD, et al.: Problems in the hemodynamic diagnosis of tricuspid insufficiency. Am Heart J 75: 173, 1968PubMedGoogle Scholar
  14. 14.
    Cha SD, Gooch AS, Maranhao V: Intracardiac phonocardiography in tricuspid regurgitation: Relation to clinical and angiographic findings. Am J Cardiol 48: 578, 1981PubMedGoogle Scholar
  15. 15.
    Cha SD, Gooch AS: Diagnosis of tricuspid regurgitation. Arch Intern Med 143: 1763, 1983PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers 1987

Authors and Affiliations

  • Junichi Yoshikawa
    • 1
  • Kiyoshi Yoshida
    • 1
  • Takashi Akasaka
    • 1
  • Masahiro Shakudo
    • 1
  • Hiroshi Kato
    • 1
  1. 1.Department of CardiologyKobe General HospitalKobeJapan

Personalised recommendations