RESUMO
M-mode, two-dimensional and Doppler echocardiography were used to assess the comparative value of each in the detection of clinically diagnosed mitral valve prolapse; 125 consecutive patients with a mid- to late systolic click, with or without a late systolic murmur, were included. There were 46 men and 79 women; their mean age was 42 years. M-mode echocardiography detected 62 of 125 cases (sensitivity 50%). Two-dimensional echocardiography was positive in 85 cases (sensitivity 68%) and 90 cases were detected with Doppler echocardiography (sensitivity 72%). When all three techniques were combined, 116 cases were correctly diagnosed (total echographic sensitivity 93%). The relative insensitivity of the M-mode technique and the additive value of two-dimensional and Doppler echocardiography in the detection of auscultatory mitral prolapse are emphasized.
Assuntos
Ecocardiografia/métodos , Prolapso da Valva Mitral/diagnóstico , Adolescente , Adulto , Idoso , Efeito Doppler , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Sensitivity and specificity of detection of mitral regurgitation was assessed by range-gated Doppler echocardiography. The degree of mitral regurgitation was also estimated by the depth and width of the regurgitant jet detected with Doppler and compared with that assessed by left ventriculography. Of 47 patients with an adequate Doppler study, 24 had no mitral regurgitation by ventriculography. All but one were also negative for mitral regurgitation by Doppler, for a specificity of 96%. Of 23 cases with mitral regurgitation documented by ventriculography, Doppler detected mitral regurgitation in 21, for a sensitivity of 92%. Two cases with mitral regurgitation undiagnosed by Doppler had mild mitral regurgitation due to papillary muscle dysfunction. All cases with rheumatic mitral regurgitation were detected. The degree of mitral regurgitation estimated with Doppler had a high correlation with that determined by ventriculography (r = 0.88, p less than 0.01).
Assuntos
Efeito Doppler , Ecocardiografia , Insuficiência da Valva Mitral/diagnóstico , Física , Adulto , Idoso , Débito Cardíaco , Diástole , Ventrículos do Coração/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Fonocardiografia , Fenômenos Físicos , Radiografia , Cardiopatia Reumática/diagnóstico , SístoleRESUMO
Prosthetic mitral valve regurgitation was evaluated by both pulsed Doppler ultrasound and left ventriculography. Pulsed Doppler ultrasound was found to have only a 20% sensitivity in detecting prosthetic mitral valve regurgitation documented by left ventriculography. Possible reasons for this poor sensitivity include 1) an eccentric jet not identified by the small pulsed Doppler sample volume; 2) prosthesis interference with the Doppler signal in the apical four chamber view; and 3) the large angle of incidence between the pulsed Doppler signal and the regurgitant jet. Mitral insufficiency, especially when not severe, may be missed by this technique. Care must be taken in interpreting negative results from a pulsed Doppler ultrasound evaluation of a prosthetic mitral valve.