Effect of heart rate on transmitral flow velocity profile and Doppler measurements of mitral valve area in patients with mitral stenosis

• Published in: European heart journal Vol. 13; no. 2; p. 152
• Main Authors: Voelker, W, Regele, B, Dittmann, H, Mauser, M, Ickrath, O, Schmid, K M, Karsch, K R
• Format: Journal Article
• Language: English
• Published: England 01-02-1992
• Subjects: Adult; Blood Flow Velocity - physiology; Blood Pressure - physiology; Cardiac Pacing, Artificial; Female; Heart Rate - physiology; Hemodynamics - physiology; Humans; Male; Middle Aged; Mitral Valve - diagnostic imaging; Mitral Valve - physiopathology; Mitral Valve Stenosis - diagnostic imaging; Mitral Valve Stenosis - physiopathology; Stroke Volume - physiology; Ultrasonography
• ISSN: 0195-668X
• DOI: 10.1093/oxfordjournals.eurheartj.a060139

To study the effect of heart rate changes on Doppler measurements of mitral valve area atrial pacing was performed in 14 patients with mitral stenosis and sinus rhythm. Continuous wave Doppler and haemodynamic measurements were performed simultaneously at rest and during pacing-induced tachycardia. (1) Mitral valve area was determined using the conventional pressure half time method. (2) Additionally, mitral valve area was calculated with a combined Doppler and thermodilution technique according to the continuity equation. (3) Simultaneous invasive measurements were used for calculation of the mitral valve area according to the Gorlin formula. With increasing heart rate (69 +/- 13-97 +/- 15-114 +/- 13 beats min-1) mitral valve area either determined by the continuity equation (1.0 +/- 0.2-1.0 +/- 0.3-1.1 +/- 0.4 cm2) or the Gorlin formula (1.2 +/- 0.3-1.2 +/- 0.4-1.3 +/- 0.4 cm2) remained constant. Both methods correlated closely not only at rest (r = 0.88, SEE = 0.11 cm2, P less than 0.001), but also during atrial pacing (first level: r = 0.95, SEE = 0.10 cm2, P less than 0.001, second level: r = 0.95, SEE = 0.13 cm2, P less than 0.001). In contrast, mitral valve area calculated according to the pressure half time method increased significantly during atrial pacing (1.0 +/- 0.3-1.8 +/- 0.5-2.0 +/- 0.5 cm2).