Objectives
To evaluate mitral-aortic flow velocity integral ratio (MAVIR) as an echocardiographic
tool to differentiate between severe and nonsevere mitral regurgitation (MR), compared
with regurgitant volume (RVol) and effective regurgitant orifice area (EROA), with
subgroup analysis in patients with calcific mitral valve, both by transthoracic (TTE)
and transesophageal (TEE) echocardiography. Also, whether MAVIR can be used as a screening
tool for severe MR.
Design
Prospective, cross-sectional, observational.
Setting
Cardiac operating room of a tertiary-care hospital.
Participants
One hundred adult patients with chronic mitral regurgitation with at least mild MR
by two-dimensional Doppler and with absence of mitral stenosis, aortic valve disease,
and rhythm other than sinus scheduled for cardiac surgery. The subgroup (n = 24) consisted
specifically of patients with a calcific mitral valve.
Interventions
Preinduction TTE and postinduction TEE in the operating room.
Measurements and Results
MAVIR, RVol, and EROA were measured in all patients both by TTE and TEE. Cohen's kappa
statistics was employed to quantify concordance among RVol, EROA, and MAVIR. Diagnostic
indices of MAVIR toward diagnosis of severe MR also were quantified.
The results showed a strong agreement, in differentiating severe from nonsevere MR,
between MAVIR and both RVol and EROA in the whole cohort (n = 100) and the subgroup
(n = 24), both by TTE and TEE. Diagnostic indices were high for MAVIR compared with
RVol and EROA in detecting severe MR, both by TTE and TEE.
Conclusion
MAVIR may be used as an echocardiographic tool to differentiate between severe and
nonsevere MR, even in patients with calcific valves. It also can be used to screen
patients for severe MR.
Key Words
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Article info
Publication history
Published online: October 08, 2022
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