Detection of diastolic mitral regurgitation using pulsed Doppler and its implications

Diastolic mitral regurgitation has been angiographically demonstratedin some patients with severe aortic regurgitation and/or nonobstructivecardiomyopathy. The purpose of this paper was two-fold: to studythe feasibility of pulsed Doppler noninvasive detection of thisunusually timed regurgitation on the basis of angiographic correlationsin a group of 21 patients with such conditions and sinus rhythmwith normal PR interval in 81% of the cases, and when diastolicmitral regurgitation was present, to study if it had clinicalimplications. Doppler detection was feasible in all cases and there were nofalse positive diagnoses. Comparison of haemodynamic data inpatients without (group A) and with (group B) diastolic mitralregurgitation showed a significant increase in the mean valuesof pressures, particularly for the mean pulmonary artery andcapillary wedge pressures (P<0.001), in group B. This study suggests that the recording of mitral flow velocityshould be routinely performed in patients with such pathologicalconditions, since the finding of diastolic mitral regurgitationmay have clinical significance.