Chronic mitral regurgitation - significance of the echocardiographic determinants in predicting severity

The aim of study was to determine the significance of the best echocardiographic parameters for assessing the severity of mitral regurgitation (MR). Methods - The study population consisted of 107 patients, mean age 52 +/- 7 y with chronic isolated non-ischaemic MR. Quantification of the MR was performed using echocardiography through the proximal isovelocity surface area method (regurgitant volume (RV) and the effective regurgitant orifice (ERO) were calculated) and the assessment of vena contracta width (VCW). Results - The ROC curve analysis and Peto odds used to differentiate between the significant (III-IV grade) and non-significant (I-II grade) MR groups of patients indicated that VCW, RV and ERO were the most powerful predictors of MR. The area under the ROC curve was 0.931, 0.944, 0.927, respectively. The cut-off values defining significant MR were:VCW >= 7 mm, RV >= 45 ml, ERO >= 0.33 cm(2). Conclusions - The most powerful predictors of severe MR are VCW, ERO and RV.