COMPARISON OF HEMODYNAMIC PRESSURE HALF-TIME METHOD AND GORLIN FORMULA WITH DOPPLER AND ECHOCARDIOGRAPHIC DETERMINATIONS OF MITRAL-VALVE AREA IN PATIENTS WITH COMBINED MITRAL-STENOSIS AND REGURGITATION

Mitral valve area determined by the Gorlin formula in patients with combined mitral stenosis and regurgitation underestimates the true orifice size. Recent data suggest Doppler ultrasound and two-dimensional echocardiography more accurately estimate the mitral valve area in patients with mixed mitral valvular disease. This study assessed the accuracy of an alternate method, the hemodynamic pressure half-time method, for mitral valve area determination in such patients. In 22 patients, 28 separate mitral valve areas were calculated by the hemodynamic pressure half-time method, the Gorlin formula, and the Gorlin formula corrected for mitral regurgitation, and were compared with results calculated by the Doppler pressure half-time method. Six patients were studied both before and after balloon mitral valvuloplasty. In addition, mitral valve areas calculated by all four methods were compared with results obtained by planimetry in 15 patients with technically optimal echocardiograms. The mitral valve areas determined by hemodynamic pressure half-time corretated closely with the valve areas determined by Doppler (r=0.90), whereas mitral valve areas determined by the Gorlin formula (both without and with correction for mitral regurgitation) did not correlate as well with the Doppler-estimated valve areas (r=0.47 and r=0.56, respectively). Correlation between the Doppler-derived mitral valve areas and the planimetered valve areas was also good (r=0.84), as was that between the mitral valve areas calculated by hemodynamic pressure half-time and those calculated by planimetry (r=0.78). The mitral valve areas calculated by the Gorlin formula, even with correction for mitral regurgitation, did not correlate well with the planimetered valve areas (r=0.30 and r=0.35, respectively). These comparisons indicate that in patients with combined mitral stenosis and regurgitation, the hemodynamic pressure half-time method is more accurate than the Gorlin formula and should be considered for hemodynamic assessment of mitral valve orifice area in patients with mixed mitral valvular disease. © 1990 Mosby-Year Book, Inc.