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Determinants of regurgitant volume in mitral regurgitation: contrasting effect of similar effective regurgitant orifice area in functional and organic mitral regurgitation
- Source :
- European heart journal. Cardiovascular Imaging. 13(4)
- Publication Year :
- 2011
-
Abstract
- Quantitative assessment of the severity of mitral regurgitation (MR) is based on the calculation of the effective regurgitant orifice (ERO), a measure of lesion severity, and of the regurgitant volume (RVol), a measure of left ventricular volume overload. We aimed at evaluating the determinants of RVol in both organic (OMR) and functional mitral regurgitation (FMR).MR severity was quantitatively assessed using the proximal isovelocity surface area (PISA) method in 240 patients, 142 with OMR and 98 patients with FMR. By definition, ERO and RVol were strongly correlated both in patients with OMR and FMR (both R = 0.90, P0.0001) but the slopes of the regression lines were significantly different (P0.0001). This difference remained significant in patients with elevated systolic pulmonary artery pressure (SPAP40 mmHg, P0.0001) but not in patients with normal SPAP (≤40 mmHg, P = 0.09). In multivariate analysis, independent determinants of RVol were ERO (P0.0001), MR mechanism (FMR/OMR) (P = 0.0003) and SPAP (P = 0.03). In patients with elevated SPAP, ERO (P0.0001), left ventricular ejection fraction (LVEF) (P = 0.03), and MR mechanism (P = 0.03) were independently associated with RVol, whereas in patients with normal SPAP, ERO (P0.0001) was the only independent determinant of RVol.In the present study, we evaluated the contrasting effect of similar lesion severity in OMR and FMR and showed that similar ERO were associated with lower RVol in FMR compared with OMR. The regurgitant volume is the result of complex interactions of anatomic lesions, LVEF, and SPAP and our results highlight the importance of taking into account these parameters when interpreting RVol values in clinical practice, especially in FMR.
- Subjects :
- Male
medicine.medical_specialty
Proximal isovelocity surface area
Heart Ventricles
Statistics as Topic
Regurgitant volume
Pulmonary Artery
Effective Regurgitant Orifice Area
Severity of Illness Index
Ventricular Function, Left
Predictive Value of Tests
Risk Factors
Internal medicine
Quantitative assessment
medicine
Health Status Indicators
Humans
Radiology, Nuclear Medicine and imaging
In patient
Functional mitral regurgitation
Retrospective Studies
Ultrasonography
Mitral regurgitation
Ejection fraction
Chi-Square Distribution
business.industry
Mitral Valve Insufficiency
Stroke Volume
General Medicine
Middle Aged
Multivariate Analysis
Cardiology
Mitral Valve
Regression Analysis
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 20472412
- Volume :
- 13
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- European heart journal. Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....d991db765d90f7af30ded33936b35fbb