This week we are going to cover our last of the three quantification methods for evaluating the severity of mitral regurgitation (MR). The past two weeks we discussed PISA and stroke volume methods. If you missed them or would like to refresh, you can find them there:
The Volumetric Method is very similar to the Stroke Volume method. It is based on the same principles as the stroke volume method. The difference is that with the volumetric method, the SV across the MV inflow is replaced with the Bi-Plane Simpson’s measurements. Let’s explore this step by step.
First lets refresh the basic concept behind both the Stroke Volume Method and the Volumetric Method.
The volumetric method provides us with:
Last week we discussed how to calculate SV of both inflow (mitral valve) and outflow (aortic valve) using the cross sectional area formulas. If you need a refresher, you can find it here! This week we will continue to use the same method for calculating the stroke volume across the aortic valve but review a more common method for calculating the LV volume.
The recommended method to obtaining volumes of the left ventricle, is by the Simpson’s Biplane measurement in both apical 4 and 2 chambers. Review our blog on best practices for performing LV volume via Biplane Simpson, here.
It will be necessary to calculate the following two values:
If you like to perform the math without the ultrasound machine help, here are the equations you’ll need:
Let’s walk through a case example utilizing this method!
This week wraps up our last method to quantify the severity of mitral regurgitation! If you’ve missed our blog series covering everything you need to know in regards to echo and MR, you’re welcome to check them out here! We hope you continue to enjoy reading our blogs and able to take away good information to implement into your department!
Andrea Fields MHA, RDCS
Zoghbi, W. A., MD, FASE, & Adams, D., RCS, RDCS, FASE. (2017). Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation. JASE, 30, 4th ser., 1-69. Retrieved June 12, 2017.