Pulmonary venous systolic flow fraction in patients with mitral regurgitation: transoesophageal echocardiography findings in relation to haemodynamic and angiographic evaluation

Summary. In patients with mitral regurgitation (MR), pulmonary venous systolic flow fraction (PVSF_fr) recorded using pulsed Doppler transoesophageal echocardiography (TEE) was compared with PVSF_fr in normal subjects, to angiographic grading and to haemodynamic parameters. PVSfr was calculated as the systolic flow velocity integral divided by total inflow integral. PVSfr is negative when systolic flow is reversed. Forty patients with MR were studied. PVSF_fr<0 was 100% sensitive for angiographic severe MR (specificity 83%). In 35 patents heart rate differed by 10 bpm or less between TEE and cath, either at rest or during stress. PVSF_fr was correlated with angiographic grade (r=-0.69, P<0.0001), with mean PCW (r=-0.61, P<0.0001), with the v-wave (r=-0.72, P<0.0001), with systolic blood pressure (r=0.48, P<0.005) and with left atrial diameter (r= -0.52, P<0.005). Stepwise forward multiple linear regression analysis revealed the v-wave, angiographic grading and systolic blood pressure to be independent predictors of PVSF_fr. PVSF_fr differed in normal subjects, patients with 0–2+ and patients with 3–4+ regurgitation. PVSF_fr is a valuable index in assessing mitral regurgitation. This index may be less dependent on equipment and operator than colour flow imaging.