A novel technique to quantify the instantaneous mitral regurgitant rate

Seth Uretsky, Farooq A. Chaudhry, Linda Gillam, Srinivasa Gurram, Sri Lakshmi Kala Bonda, Harikrishna Ponnam, Eric Bader, Naganath Thota, Randy Cohen, Azhar Supariwala, Steven D. Wolff

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The systolic variation of mitral regurgitation (MR) is a pitfall in its quantification. Current recommendations advocate using quantitative echocardiographic techniques that account for this systolic variation. While prior studies have qualitatively described patterns of systolic variation no study has quantified this variation. Methods. This study includes 41 patients who underwent cardiovascular magnetic resonance (CMR) evaluation for the assessment of MR. Systole was divided into 3 equal parts: early, mid, and late. The MR jets were categorized as holosystolc, early, or late based on the portions of systole the jet was visible. The aortic flow and left ventricular stroke volume (LVSV) acquired by CMR were plotted against time. The instantaneous regurgitant rate was calculated for each third of systole as the difference between the LVSV and the aortic flow. Results: The regurgitant rate varied widely with a 1.9-fold, 3.4-fold, and 1.6-fold difference between the lowest and highest rate in patients with early, late, and holosystolic jets respectively. There was overlap of peak regurgitant rates among patients with mild, moderate and severe MR. The greatest variation of regurgitant rate was seen among patients with mild MR. Conclusion: CMR can quantify the systolic temporal variation of MR. There is significant variation of the mitral regurgitant rate even among patients with holosystolic MR jets. These findings highlight the need to use quantitative measures of MR severity that take into consideration the temporal variation of MR.

Original languageEnglish (US)
Article number74
JournalJournal of Cardiovascular Magnetic Resonance
Volume15
Issue number1
DOIs
StatePublished - Sep 3 2013
Externally publishedYes

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Mitral Valve Insufficiency
Systole
Magnetic Resonance Spectroscopy
Stroke Volume

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Family Practice

Cite this

Uretsky, Seth ; Chaudhry, Farooq A. ; Gillam, Linda ; Gurram, Srinivasa ; Bonda, Sri Lakshmi Kala ; Ponnam, Harikrishna ; Bader, Eric ; Thota, Naganath ; Cohen, Randy ; Supariwala, Azhar ; Wolff, Steven D. / A novel technique to quantify the instantaneous mitral regurgitant rate. In: Journal of Cardiovascular Magnetic Resonance. 2013 ; Vol. 15, No. 1.
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abstract = "Background: The systolic variation of mitral regurgitation (MR) is a pitfall in its quantification. Current recommendations advocate using quantitative echocardiographic techniques that account for this systolic variation. While prior studies have qualitatively described patterns of systolic variation no study has quantified this variation. Methods. This study includes 41 patients who underwent cardiovascular magnetic resonance (CMR) evaluation for the assessment of MR. Systole was divided into 3 equal parts: early, mid, and late. The MR jets were categorized as holosystolc, early, or late based on the portions of systole the jet was visible. The aortic flow and left ventricular stroke volume (LVSV) acquired by CMR were plotted against time. The instantaneous regurgitant rate was calculated for each third of systole as the difference between the LVSV and the aortic flow. Results: The regurgitant rate varied widely with a 1.9-fold, 3.4-fold, and 1.6-fold difference between the lowest and highest rate in patients with early, late, and holosystolic jets respectively. There was overlap of peak regurgitant rates among patients with mild, moderate and severe MR. The greatest variation of regurgitant rate was seen among patients with mild MR. Conclusion: CMR can quantify the systolic temporal variation of MR. There is significant variation of the mitral regurgitant rate even among patients with holosystolic MR jets. These findings highlight the need to use quantitative measures of MR severity that take into consideration the temporal variation of MR.",
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Uretsky, S, Chaudhry, FA, Gillam, L, Gurram, S, Bonda, SLK, Ponnam, H, Bader, E, Thota, N, Cohen, R, Supariwala, A & Wolff, SD 2013, 'A novel technique to quantify the instantaneous mitral regurgitant rate', Journal of Cardiovascular Magnetic Resonance, vol. 15, no. 1, 74. https://doi.org/10.1186/1532-429X-15-74

A novel technique to quantify the instantaneous mitral regurgitant rate. / Uretsky, Seth; Chaudhry, Farooq A.; Gillam, Linda; Gurram, Srinivasa; Bonda, Sri Lakshmi Kala; Ponnam, Harikrishna; Bader, Eric; Thota, Naganath; Cohen, Randy; Supariwala, Azhar; Wolff, Steven D.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 15, No. 1, 74, 03.09.2013.

Research output: Contribution to journalArticle

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AU - Uretsky, Seth

AU - Chaudhry, Farooq A.

AU - Gillam, Linda

AU - Gurram, Srinivasa

AU - Bonda, Sri Lakshmi Kala

AU - Ponnam, Harikrishna

AU - Bader, Eric

AU - Thota, Naganath

AU - Cohen, Randy

AU - Supariwala, Azhar

AU - Wolff, Steven D.

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N2 - Background: The systolic variation of mitral regurgitation (MR) is a pitfall in its quantification. Current recommendations advocate using quantitative echocardiographic techniques that account for this systolic variation. While prior studies have qualitatively described patterns of systolic variation no study has quantified this variation. Methods. This study includes 41 patients who underwent cardiovascular magnetic resonance (CMR) evaluation for the assessment of MR. Systole was divided into 3 equal parts: early, mid, and late. The MR jets were categorized as holosystolc, early, or late based on the portions of systole the jet was visible. The aortic flow and left ventricular stroke volume (LVSV) acquired by CMR were plotted against time. The instantaneous regurgitant rate was calculated for each third of systole as the difference between the LVSV and the aortic flow. Results: The regurgitant rate varied widely with a 1.9-fold, 3.4-fold, and 1.6-fold difference between the lowest and highest rate in patients with early, late, and holosystolic jets respectively. There was overlap of peak regurgitant rates among patients with mild, moderate and severe MR. The greatest variation of regurgitant rate was seen among patients with mild MR. Conclusion: CMR can quantify the systolic temporal variation of MR. There is significant variation of the mitral regurgitant rate even among patients with holosystolic MR jets. These findings highlight the need to use quantitative measures of MR severity that take into consideration the temporal variation of MR.

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