Comparison of the usefulness of Doppler pressure half-time in mitral stenosis in patients <65 and ≥65 years of age

Vivian M. Abascal, Pedro R. Moreno, Leonardo Rodriguez, Victor M. Monterroso, Igor F. Palacios, Arthur E. Weyman, Ravin Davidoff

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

Abstract

Doppler pressure half-time is a reliable method for estimating mitral valve area when net left atrial and ventricular compliance remain stable. The accuracy of Doppler pressure half-time in estimating mitral valve area in older patients is unknown. We studied 80 patients (65 women and 15 men, aged 56 ± 14 years) with cardiac catheterization and echocardiography. Mitral valve area was calculated using the Gorlin formula and by the Doppler pressure half-time method. Patients were stratified into those aged <65 years (n = 57), and those aged ≥65 years (n = 23). The discordance between pressure half-time and Gorlin-derived mitral valve area was assessed and related to multiple clinical, echocardiographic, and hemodynamic variables. The difference between pressure half-time and Gorlin-derived mitral valve area was greater in the older than in the younger patient (0.34 ± 0.30 vs 0.15 ± 0.27 cm2, p = 0.009) but the older group had smaller mitral valve areas by the Gorlin method (0.72 ± 0.18 vs 0.89 ± 0.32 cm2, p = 0.02) and lower cardiac output. The difference between pressure half-time and Gorlin remained greater in the group of older patients (0.32 ± 0.30 vs 0.19 ± 0.22 cm2, p = 0.04), even when the analysis was restricted to patients with similar mitral valve area (<1 cm2 by the Gorlin method). Using multivariate analysis, age ≥65 years remained the only significant predictor of the discrepancy between pressure half-time and Gorlin mitral valve area. Thus, when compared with Gorlin-derived mitral valve area, pressure half-time overestimated valve area in older patients, and this technique for estimating mitral valve area should be used with caution in patients ≥65 years of age.

Original languageEnglish
Pages (from-to)1390-1393
Number of pages4
JournalAmerican Journal of Cardiology
Volume78
Issue number12
DOIs
StatePublished - 1996

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