Tissue doppler-derived isovolumic acceleration parameters in organic mitral regurgitation

Background and aim of the study: New, quantitative, reliable and practical echocardiographic parameters are required for grading the severity of mitral regurgitation (MR). Thus, an investigation was made of tissue Doppler imaging (TDI) parameters in MR patients with a preserved left ventricular ejection fraction (LVEF). Methods: Transthoracic echocardiography was performed in 96 consecutive patients with varying degrees of MR but with a preserved LVEF. In addition, TDI-derived systolic velocities of the mitral and tricuspid annulus were recorded. The results obtained were compared with those from 31 age- and gender-matched healthy controls. Results: The study patients were classified according to MR severity: mild-moderate (n = 65) or severe (n = 31). Although isovolumic myocardial acceleration (IVA) and peak myocardial velocity during isovolumic contraction (IVV) showed similar values in all groups, the acceleration time (AT) was higher in the severe MR group than in mild or moderate MR patients (p <0.001). The AT cut-off value to predict severe MR was 35 ms (sensitivity 74.2%, specificity 58.5%). Conclusion: AT has the potential to differentiate severe MR from non-severe MR in patients with a preserved LVEF. These findings suggest that TDI of the mitral annulus might serve as a novel method for assessing MR severity.