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Comparison of quantitative and semiquantitative methods for assessing mitral regurgitation by transesophageal echocardiography
Semiquantitative grading of mitral regurgitation (MR) by transesophageal echocardiography (TEE) is widely used for clinical decision making. However, the relation between semiquantitative grading by biplane or multiplane TEE and quantitative measures remains undetermined. Biplane or multiplane TEE w...
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| Published in: | The American journal of cardiology 2001, Vol.87 (1), p.66-70 |
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| creator | Pu, Min Thomas, James D Vandervoort, Pieter M Stewart, William J Cosgrove, Delos M Griffin, Brian P |
| description | Semiquantitative grading of mitral regurgitation (MR) by transesophageal echocardiography (TEE) is widely used for clinical decision making. However, the relation between semiquantitative grading by biplane or multiplane TEE and quantitative measures remains undetermined. Biplane or multiplane TEE was performed in 113 patients in the operating room. MR severity was graded from 1 to 4+ by Doppler color flow mapping. MR was quantified using the thermodilution-Doppler method as mitral regurgitant stroke volume (RSV) derived from the difference between total mitral inflow measured by pulsed Doppler and forward flow measured by thermodilution. Mitral regurgitant orifice area (ROA) was calculated by RSV divided by mitral regurgitant velocity. RSV and ROA were also calculated using the proximal isovelocity surface area method. RSV and ROA significantly correlated with the semiquantitative grading either by TEE or angiogram in a nonlinear fashion, with the best fit being given by an exponential model with correlation coefficients from 0.73 to 0.87 (p |
| doi_str_mv | 10.1016/S0002-9149(00)01274-1 |
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2) was sixfold larger than the smallest. Patients with 2 to 3+ MR had significantly variable RSV and ROA (range 21 to 91 ml and 0.12 to 0.65 cm
2, respectively). Color flow mapping by biplane or multiplane TEE or angiography is able to categorize precisely mild (≤2+) and severe (≥3+) MR, but cannot accurately determine actual hemodynamic load of MR in more severe degrees of MR.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(00)01274-1</identifier><identifier>PMID: 11137836</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular disease ; Comparative studies ; Echocardiography, Transesophageal - methods ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Hemodynamics - physiology ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitral Valve Insufficiency - diagnostic imaging ; Mitral Valve Insufficiency - physiopathology ; Space life sciences ; Stroke Volume - physiology ; Tests ; Thermodilution</subject><ispartof>The American journal of cardiology, 2001, Vol.87 (1), p.66-70</ispartof><rights>2001 Excerpta Medica Inc.</rights><rights>2001 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Jan 1, 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-b78397aeca70e11b125b1d37b25301befe8c326dc57ed404567706600546f7973</citedby><cites>FETCH-LOGICAL-c482t-b78397aeca70e11b125b1d37b25301befe8c326dc57ed404567706600546f7973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=853494$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11137836$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pu, Min</creatorcontrib><creatorcontrib>Thomas, James D</creatorcontrib><creatorcontrib>Vandervoort, Pieter M</creatorcontrib><creatorcontrib>Stewart, William J</creatorcontrib><creatorcontrib>Cosgrove, Delos M</creatorcontrib><creatorcontrib>Griffin, Brian P</creatorcontrib><title>Comparison of quantitative and semiquantitative methods for assessing mitral regurgitation by transesophageal echocardiography</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Semiquantitative grading of mitral regurgitation (MR) by transesophageal echocardiography (TEE) is widely used for clinical decision making. However, the relation between semiquantitative grading by biplane or multiplane TEE and quantitative measures remains undetermined. Biplane or multiplane TEE was performed in 113 patients in the operating room. MR severity was graded from 1 to 4+ by Doppler color flow mapping. MR was quantified using the thermodilution-Doppler method as mitral regurgitant stroke volume (RSV) derived from the difference between total mitral inflow measured by pulsed Doppler and forward flow measured by thermodilution. Mitral regurgitant orifice area (ROA) was calculated by RSV divided by mitral regurgitant velocity. RSV and ROA were also calculated using the proximal isovelocity surface area method. RSV and ROA significantly correlated with the semiquantitative grading either by TEE or angiogram in a nonlinear fashion, with the best fit being given by an exponential model with correlation coefficients from 0.73 to 0.87 (p <0.001). Substantially increased RSV and ROA were observed in MR grades of ≥3+. In the same grades of 3+ or 4+ MR, the largest RSV was 4 times larger than the smallest (190 to 220 vs 44 to 45 ml), and the largest ROA (1.82 to 2.0 vs 0.26 to 0.27 cm
2) was sixfold larger than the smallest. Patients with 2 to 3+ MR had significantly variable RSV and ROA (range 21 to 91 ml and 0.12 to 0.65 cm
2, respectively). Color flow mapping by biplane or multiplane TEE or angiography is able to categorize precisely mild (≤2+) and severe (≥3+) MR, but cannot accurately determine actual hemodynamic load of MR in more severe degrees of MR.</description><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Comparative studies</subject><subject>Echocardiography, Transesophageal - methods</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Heart</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral Valve Insufficiency - diagnostic imaging</subject><subject>Mitral Valve Insufficiency - physiopathology</subject><subject>Space life sciences</subject><subject>Stroke Volume - physiology</subject><subject>Tests</subject><subject>Thermodilution</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqF0c-L1TAQB_Agivt29U9QioLooTrTNE17WuSx_oAFD-o5pMm0L0vbdJN24V38282-91jRi6eQ4TPDMF_GXiC8R8Dqw3cAKPIGy-YtwDvAQpY5PmIbrGWTY4P8Mds8kDN2HuNN-iKK6ik7Q0Qua15t2K-tH2cdXPRT5rvsdtXT4ha9uDvK9GSzSKP7qzjSsvM2Zp0PmY6RYnRTn41uCXrIAvVr6A80zWv3WapOyfh5p3tKgMzOGx2s833Q827_jD3p9BDp-em9YD8_Xf3Yfsmvv33-uv14nZuyLpa8Tcs2UpPREgixxUK0aLlsC8EBW-qoNryorBGSbAmlqKSEqgIQZdXJRvIL9uY4dw7-dqW4qNFFQ8OgJ_JrVBJELRCbBF_9A2_8Gqa0myo4cAkoi4TEEZngYwzUqTm4UYe9QlD36ahDOur-9ApAHdJRmPpenoav7Uj2T9cpjgRen4CORg9dup5x8cHVgpdNmdTlUVG62J2joKJxNBmyLpBZlPXuP4v8BrHorbQ</recordid><startdate>2001</startdate><enddate>2001</enddate><creator>Pu, Min</creator><creator>Thomas, James D</creator><creator>Vandervoort, Pieter M</creator><creator>Stewart, William J</creator><creator>Cosgrove, Delos M</creator><creator>Griffin, Brian P</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>2001</creationdate><title>Comparison of quantitative and semiquantitative methods for assessing mitral regurgitation by transesophageal echocardiography</title><author>Pu, Min ; Thomas, James D ; Vandervoort, Pieter M ; Stewart, William J ; Cosgrove, Delos M ; Griffin, Brian P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-b78397aeca70e11b125b1d37b25301befe8c326dc57ed404567706600546f7973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Comparative studies</topic><topic>Echocardiography, Transesophageal - methods</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Heart</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitral Valve Insufficiency - diagnostic imaging</topic><topic>Mitral Valve Insufficiency - physiopathology</topic><topic>Space life sciences</topic><topic>Stroke Volume - physiology</topic><topic>Tests</topic><topic>Thermodilution</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pu, Min</creatorcontrib><creatorcontrib>Thomas, James D</creatorcontrib><creatorcontrib>Vandervoort, Pieter M</creatorcontrib><creatorcontrib>Stewart, William J</creatorcontrib><creatorcontrib>Cosgrove, Delos M</creatorcontrib><creatorcontrib>Griffin, Brian P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pu, Min</au><au>Thomas, James D</au><au>Vandervoort, Pieter M</au><au>Stewart, William J</au><au>Cosgrove, Delos M</au><au>Griffin, Brian P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of quantitative and semiquantitative methods for assessing mitral regurgitation by transesophageal echocardiography</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2001</date><risdate>2001</risdate><volume>87</volume><issue>1</issue><spage>66</spage><epage>70</epage><pages>66-70</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Semiquantitative grading of mitral regurgitation (MR) by transesophageal echocardiography (TEE) is widely used for clinical decision making. However, the relation between semiquantitative grading by biplane or multiplane TEE and quantitative measures remains undetermined. Biplane or multiplane TEE was performed in 113 patients in the operating room. MR severity was graded from 1 to 4+ by Doppler color flow mapping. MR was quantified using the thermodilution-Doppler method as mitral regurgitant stroke volume (RSV) derived from the difference between total mitral inflow measured by pulsed Doppler and forward flow measured by thermodilution. Mitral regurgitant orifice area (ROA) was calculated by RSV divided by mitral regurgitant velocity. RSV and ROA were also calculated using the proximal isovelocity surface area method. RSV and ROA significantly correlated with the semiquantitative grading either by TEE or angiogram in a nonlinear fashion, with the best fit being given by an exponential model with correlation coefficients from 0.73 to 0.87 (p <0.001). Substantially increased RSV and ROA were observed in MR grades of ≥3+. In the same grades of 3+ or 4+ MR, the largest RSV was 4 times larger than the smallest (190 to 220 vs 44 to 45 ml), and the largest ROA (1.82 to 2.0 vs 0.26 to 0.27 cm
2) was sixfold larger than the smallest. Patients with 2 to 3+ MR had significantly variable RSV and ROA (range 21 to 91 ml and 0.12 to 0.65 cm
2, respectively). Color flow mapping by biplane or multiplane TEE or angiography is able to categorize precisely mild (≤2+) and severe (≥3+) MR, but cannot accurately determine actual hemodynamic load of MR in more severe degrees of MR.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11137836</pmid><doi>10.1016/S0002-9149(00)01274-1</doi><tpages>5</tpages></addata></record> |
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| subjects | Biological and medical sciences Cardiology. Vascular system Cardiovascular disease Comparative studies Echocardiography, Transesophageal - methods Endocardial and cardiac valvular diseases Female Heart Hemodynamics - physiology Humans Male Medical sciences Middle Aged Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - physiopathology Space life sciences Stroke Volume - physiology Tests Thermodilution |
| title | Comparison of quantitative and semiquantitative methods for assessing mitral regurgitation by transesophageal echocardiography |
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