Assessment of Mitral Stenosis by Doppler Echocardiography: Influence of Atrial Fibrillation of Doppler Pressure Half-Time

Kim, Kwon Sam; Choi, Chul Joon; Choue, Chung Whee; Kim, Myung Shick; Song, Jung Sang; Bae, Jong Hoa

Abstract

Atrial fibrillation in mitral stenosis(MS) may be cause of error in calculation of mitral valve area(MVA) by Doppler derived pressure half-time(PHT) method. This is due to changes of peak velocity and diastolic slope in mitral inflow Doppler spectrum in cases of assoociated with atrial fibrillation. However, few data exist regarding the effect of atrial fibrillation on the validity of this method. Two hundreds and three patients with mitral stenosis were studied by Doppler echocardiography and two-dimensional echocardiography(2DE) to assess whether atrial fibrillation affected the calcullation of MVA. Total patients was divided into four groups according to the accompanied mitral or aortic regurgitation. Ninety patients had mitral stenosis only(group 1), 45 patients had mitral stenosis only(group 2), 54 patients were combined with aortic regurgitation(group 3) and 14 patients were combined with both mitral and aortic regurgitation(group 4). And then, each group was divided into sinus rhythm subgroup and atrial fibrillation subgroup respectively. In total patients, Doppler echocardiographic indices(pressure half-time, mean pressure gradient, peak pressure gradient and peak velocity) were correlated significantly with 2DE-MVA in both patients with sinus rhythm and patients, with atrial fibrillation(P<0.005). In group 1 patients, Doppler echocardiographic indices were significantly correlated with 2DE-MVA in both patients with sinus rhythm and patients with atrial fibrillation(P<0.005). In group 2 patients, these Doppler derived indices were significantly correlated with 2DE-MVA in both patients with sinuns rhythm and patients with atrial fibrillation(P<0.005). In group 3 patients, only pressure half-time was significantly correlated with 2DE-MVA in both patients with sinus rhythm and patients with atrial fibrillation(P>0.005). In group 4 patients, pressure half-time was significantly correlated in patients with atrial fibrillation(P<0.005). Therefore, Doppler echocardiography can estimates mitral valve area in patients with mitral stenosis associated with mitral and aortic regurgitation regardless of presence of the atrial fibrillation.