Color Doppler echocardiography to assess mitral regurgitation

The article is professionally consulted by a Doctor of Radiology, Department of Diagnostic Imaging - Vinmec Central Park International General Hospital.

Doppler echocardiography is a high-precision mitral regurgitation echocardiogram. This method is used very often in clinical practice to confirm and evaluate the degree of mitral regurgitation.

The mitral valve is a heart valve located between the left atrium and the left ventricle, which plays an important role in helping to ensure that blood flows through the heart at the right time and in the right direction. The normal physiology of the mitral valve is as follows: when the mitral valve is open, blood flows from the left atrium to the left ventricle. After the left ventricle is filled with blood, the mitral valve closes tightly to prevent blood from flowing back into the left atrium.
Mitral regurgitation is a condition in which the mitral valve does not close properly, allowing blood to flow back into the left atrium. There are many causes of mitral regurgitation, which can be due to birth defects that appear during pregnancy or as a result of certain medical conditions such as rheumatism, endocarditis, hypertension, myocardial infarction. heart ,...
Mild mitral regurgitation is usually not a cause for concern and does not require treatment. However, if mitral regurgitation is severe, it can cause many dangerous complications such as heart failure, atrial fibrillation, pulmonary hypertension, etc. There are many methods used to diagnose and evaluate regurgitation. mitral valve such as electrocardiogram, X-ray, echocardiogram,... In which, Doppler echocardiography is one of the most commonly used methods, helping to determine the degree of regurgitation and its influence. to heart function.

Doppler echocardiography is a non-invasive method with high accuracy, color ultrasound images are easy to observe. This is a technique that uses high-frequency ultrasound (3-5 MHz) to probe and observe the heart's movement, function of the heart muscle and heart valves, diagnose and monitor the effectiveness of treatment of diseases. cardiovascular theory.
Doppler echocardiography is used routinely in clinical practice to confirm and evaluate the degree of mitral regurgitation. Many parameters in echocardiography such as open current area, open current root width, open current length, ratio of open current area to left atrial area, effective hole area, ... help to evaluate exact degree of valve regurgitation.

2.1. Color Doppler ultrasound Mitral regurgitation by color Doppler ultrasound method is widely used to diagnose and evaluate the degree of mitral regurgitation. Mitral regurgitation on Doppler ultrasound is divided into 4 degrees from 1/4 to 4/4. Or it can also be assessed by degrees from mild (1+), moderate (2+), many (3+) and very many (4+). Color Doppler ultrasound helps to see the image of the backflow color. to the left atrium. Based on the spread of the retrograde color flow, the mitral valve clearance can be estimated. To evaluate more specifically the degree of valve regurgitation, parameters such as:
Maximum length of the retrograde flow in the left atrium The ratio of open flow area to left atrial area This method is accurate for central mitral regurgitation, however for large eccentric regurgitation lines, mitral regurgitation should be calculated in 1 degree increments. When using echocardiography to evaluate mitral regurgitation, it is necessary to pay attention to factors that can affect the accuracy such as:
When transesophageal echocardiography to evaluate mitral regurgitation, if the patient is taking antihypertensive drugs, , the degree of mitral regurgitation will decrease compared to normal. If mitral regurgitation is evaluated intraoperatively, mitral regurgitation will depend on preload and afterload. A reliable indicator to help assess the degree of mitral regurgitation is the opening flow width when passing through the opening (vena contracta). However, this method requires a high resolution Doppler ultrasound machine due to the need to zoom in.
Another indicator is the effective opening area (ERO) calculated by the PISA method based on the flow phenomenon through the narrow funnel-shaped opening. The PISA phenomenon often signals a moderate mitral regurgitation, especially when pulsed Doppler is used.

2.2. Pulsed Doppler echocardiography Pulsed Doppler echocardiography (PW Doppler) can assess the degree of valvular regurgitation, especially in severe cases. If an inversion of the pulmonary venous flow systolic spectrum occurs, it indicates very severe mitral regurgitation. If there is a decrease in the systolic pulmonary venous outflow spectrum when left ventricular function is normal, then mitral regurgitation is severe; however, the assessment will be inaccurate if the patient has atrial fibrillation or is already dysfunctional. severe left ventricle.
The Cardiovascular Center at Vinmec International General Hospital is equipped with a modern echocardiogram system and equipment on par with the most prestigious hospitals in the world to support doctors in the treatment of diseases. cardiology for patients. Along with that is a team of experts including experienced professors and doctors who have successfully performed many surgeries for patients with heart disease.
If you have a need for consultation and examination at Vinmec Hospitals under the national health system, please book an appointment on the website for service.