Abstract 12680: A Comparative Assessment of Echocardiographic Parameters for Determining Mitral Regurgitation Severity

Abstract

Introduction: Guidelines suggest the use of several echocardiographic (Echo) parameters to assess mitral regurgitation (MR) severity using an integrated approach without guidance as how to weight each parameter. The aim of this study is to develop a hierarchy for Echo parameters of MR severity. Methods: This prospective study included 80 patients (63 ± 13 yrs, male 57%) with MR. Echo parameters including in this analysis were effective regurgitant orifice area (EROA), vena contracta (VC), LV EDD, color Doppler jet/LA area, the presence of a flail leaflet, and the presence of pulmonary vein wave systolic reversal. MR volume by MRI was calculated as the difference between the LV stroke volume and forward flow. A backward elimination multivariate linear regression analysis was used to determine which Echo parameters predicted regurgitant volume by MRI. Results: Individual Echo parameters that correlated best with MR volume by MRI were EROA (r = 0.68, p <0.0001), VC (r = 0.62, p < 0.0001), and the presence of a flail (r = 0.48, p < 0.0001) (figure 1). In the linear regression analysis, significant predictors of MR volume by MRI were EROA, VC and the presence of a flail with a moderate correlation with MR volume by MRI (overall model r = 0.72. p <0.0001). LV EDD, color Doppler jet/LA area, and the presence of reversal of the pulmonary systolic wave having no effect on the model. Of the 3 parameters in the model, EROA correlated the best with MR volume by MRI, followed by VC and the presence of a flail leaflet. Conclusions: Echocardiographic parameters for assessing MR had only a moderate correlation with MR volume by MRI. The model that best predicted MR volume by MRI included EROA, VC, and the presence of a flail leaflet. EROA was the best at predicting MR volume by MRI, followed by VC and the presence of a flail leaflet. Not all of the recommended echocardiographic measures of MR severity were helpful in predicting MR volume by MRI. .