Echocardiography quantification of mitral valve defects

Echocardiography led during the last 10 years to a definite improvement of quality of cardiological diagnostics. In addition to an excellent recording of morphological and functional changes of the heart by 1- and two-dimensional images Doppler-echocardiography allows the semiquantitative judgement of the hemodynamic effect. Echocardiographic techniques try to measure the mitral valve area in cases of mitral stenosis resp. the leak area in cases of mitral insufficiency to assess the importance of valve disorder. These parameters are constant values, whereas the transmitral diastolic pressure gradient and the regurgitant volume are variable. The assessment of the mitral valve area and the graduation of the mitral valve stenosis is possible with a high diagnostic relevance using planimetrical and/or pressure-half-time methods. The applicability of the pressure-half-time method depends on the nature of the pressure decrease and an individual review is necessary. The measurement of the leak area is much more problematical. The assessment of the functional regurgitation area by colour coded Doppler-echocardiography seems to be favourite, but not validated up to now. A semiquantitative judgement of a mitral valve insufficiency is successful in evaluating of intensity, width and area of the regurgitant cloud. The evaluation of raw data of flow patterns will provide further information in future.