[Meaning of mosaic color area in mitral regurgitation. Echocardiographic transesophageal study]. / Significado da área de mosaico cor na regurgitação mitral. Estudo ecocardiográfico transesofágico.

ABSTRACT

OBJECTIVE: The purpose of our study was to analyse the meaning of total and mosaic color Doppler area of the mitral regurgitation jet, in terms of the degree of mitral regurgitation severity. PATIENTS In and out patients referred to the Echocardiographic Laboratory of Gregorio Marañon General Hospital, Madrid. SETTING: Transesophageal echocardiographic prospective study MATERIAL AND METHODS: By pulsed and color Doppler transesophageal approach we studied 94 consecutive patients with mitral regurgitation diagnosis. We divided the entire population in three groups according to the degree of transthoracic mitral regurgitation severity and mitral regurgitation color area index (Groups I, II and III). In each patient we systematically measured the regurgitant maximal area (AT) and of the aliasing color area, as well as maximal peak velocity (VIS) and area (AIS) of the reversed pulmonary venous pulsed Doppler flow obtained at the level of the left upper pulmonary vein. RESULTS: For the group I, color Doppler AT was 411 +/- 315 mm2 and AN was 204 +/- 123 mm2 (R = 0.25), pulmonary venous pulsed Doppler VIS was 4 +/- 8 cm/sec (R = NS for AT and 0.79 for AN) and AIS was 9 +/- 6 mm2 (R = NS for AT and 0.82 for AN). In the group II, color Doppler AT was 802 +/- 447 mm2, AN was 671 +/- 307 mm2 (R = 0.42). the pulmonary venous pulsed Doppler VIS was 22 +/- 12 cm/sec (R = NS for AT and 0.66 for AN). In the group III we obtained an AT value of 1174 +/- 462 mm2 and an AN value of 1092 +/- 417 mm2 (R = 0.62). In this group the pulmonary venous pulsed Doppler VIS was 50 +/- 13 cm/sec (R = 0.57 for AT and 0.76 for AN) and the correspondent AIS was 671 +/- 570 mm2 (R = 0.38 for AT and 0.91 for AN). CONCLUSIONS: Mosaic transesophageal echocardiographic color Doppler area of mitral regurgitant jets has a direct relationship with the reversal criteria of pulsed Doppler pulmonary venous flow. This relationship is greater than the total color Doppler area of the same regurgitant jet. The mosaic color Doppler area of mitral regurgitant jets is a more correct estimation of the systolic variation of left atrial pressure, when compared with the total color area of mitral regurgitation.