Mancuso FJN, Moisés VA, Almeida DR, Oliveira WA, Poyares D, Brito FS, de Paola AAV, Carvalho ACC, Campos O. Criteria for mitral regurgitation classification were inadequate for dilated cardiomyopathy.
Arq Bras Cardiol 2013;
101:457-65. [PMID:
24100692 PMCID:
PMC4081170 DOI:
10.5935/abc.20130200]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/07/2013] [Indexed: 01/20/2023] Open
Abstract
Background
Mitral regurgitation (MR) is common in patients with dilated cardiomyopathy (DCM).
It is unknown whether the criteria for MR classification are inadequate for
patients with DCM.
Objective
We aimed to evaluate the agreement among the four most common echocardiographic
methods for MR classification.
Methods
Ninety patients with DCM were included. Functional MR was classified using four
echocardiographic methods: color flow jet area (JA), vena contracta (VC),
effective regurgitant orifice area (ERO) and regurgitant volume (RV). MR was
classified as mild, moderate or important according to the American Society of
Echocardiography criteria and by dividing the values into terciles. The Kappa test
was used to evaluate whether the methods agreed, and the Pearson correlation
coefficient was used to evaluate the correlation between the absolute values of
each method.
Results
MR classification according to each method was as follows: JA: 26 mild, 44
moderate, 20 important; VC: 12 mild, 72 moderate, 6 important; ERO: 70 mild, 15
moderate, 5 important; RV: 70 mild, 16 moderate, 4 important. The agreement was
poor among methods (kappa = 0.11; p < 0.001). It was observed a strong
correlation between the absolute values of each method, ranging from 0.70 to 0.95
(p < 0.01) and the agreement was higher when values were divided into terciles
(kappa = 0.44; p < 0.01)
Conclusion
The use of conventional echocardiographic criteria for MR classification seems
inadequate in patients with DCM. It is necessary to establish new cutoff values
for MR classification in these patients.
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