Temporal variability of color Doppler jet areas in patients with mitral and aortic regurgitation

Abstract

The temporal variability of color flow jets during regurgitation has not been systematically examined. We therefore analyzed color Doppler images in 52 patients (29 with mitral regurgitation and 23 with aortic regurgitation) for frame-to-frame variability in the size of the regurgitant color jet. Planimetered jet areas varied markedly throughout the flow period, with the difference between the largest and smallest mitral regurgitant jets ranging from 1.1 to 11.9 cm 2 in individual patients. Maximal and minimal aortic regurgitant jets varied from 1.5 to 6.6 cm 2 between frames. The point during the cardiac cycle at which the largest regurgitant jet area was recorded also varied markedly for mitral and aortic lesions. Mitral regurgitant jets peaked at 51% of systole, with a range from 9% to 100%. The point during diastole at which the maximal aortic regurgitant jet was recorded varied from 2% to 84%, with a mean of 31.2% of the diastolic period. The persistence of the flow disturbance was examined as the percent of systole or diastole during which the maximal jet area remained at least 50% or 75% of its maximal size. Mitral regurgitant jets remained at least one-half maximal size for a mean of 60.7% (range, 20% to 90%) of systole, but remained at 75% of maximal size for a mean of only 39% of systole. Aortic regurgitant jets persisted at over one-half maximal size for a mean of 63.2% (range, 30% to 90%) of diastole, but sustained 75% of maximal size for a mean of only 44% of diastole. Thus regurgitant jet area is characterized by marked temporal variability in onset, maximal size, and persistence. This variability in color flow Doppler recordings has important clinical implications for understanding regurgitant physiology, and may be relevant for quantitative approaches to valvular regurgitation by color flow Doppler imaging.