Utility of the Mitral Valve Doppler Velocity Index in Detecting Significant Mitral Regurgitation Post-Surgical Mitral Valve Repair

Abstract

Background: The mitral valve (MV) Doppler velocity index (DVI) (velocity time integral ratio of the continuous-wave MV and pulsed-wave left ventricular outflow tract (LVOT) measurements) is useful in the detection of MV prosthesis dysfunction (stenosis or regurgitation). The value of this Doppler velocity index (DVI) in the detection of significant mitral regurgitation (MR) post-surgical MV repair is investigated in this large dataset. Methods: A retrospective database search for surgical MV repair transthoracic echocardiograms performed between 2004 and 2019 at the Prince Charles Hospital was executed. Two groups (Group 1 - moderate or more MR and Group 2 - trace or no MR) were compared. DVI was calculated in studies with no or trace aortic regurgitation and no significant LVOT or MV obstruction. For Group 2, studies with a mean MV pressure gradient >3 mmHg were also excluded. Results: Of 7,739 MV repair studies in the database, 1,303 studies in 728 patients (aged 62 ± 17 years, 67% males) met the study criteria. There were 561 studies in Group 1 and 741 studies in Group 2. There was a significant difference in DVI between Group 1 (2.21 ± 0.68) and Group 2 (1.92 ± 0.48, p < 0.0001). The receiver operator curve (ROC) analysis identified a cut-off of 2.13 for differentiating between Groups 1 and 2 with a sensitivity and specificity of 51.69% and 70.72%, respectively and an area under the curve (AUC) of 0.634. Conclusions: A DVI >2.13 may be useful in detecting significant MR following MV repair, especially when MR severity is difficult to evaluate by traditional methods.