{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:23:00Z","timestamp":1760782980380,"version":"build-2065373602"},"reference-count":11,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[1996,5]]},"abstract":"<jats:p>OBJECTIVE: To compare the value of echo score with that of Doppler subvalvar flow broadening in deciding the type of mitral stenosis surgery. PATIENTS: 30 patients, mean age 47 years, with severe stenosis undergoing surgery were divided into two groups according to type of surgery: open heart commissurotomy (group 1, n = 12), or prosthesis (group 2, n = 18). A control group of 10 patients with prosthesis served as reference, representing mild stenosis without subvalvar connection. METHODS: For echo, the score proposed by Wilkins for cross sectional imaging was used. For Doppler, the flow diameters were measured in cm by an independent examiner from the long axis view in early diastole at two levels: (1) at the level of the stenosis (origin flow diameter), and (2) 1.5 cm downstream from the stenosis in the left ventricle (subvalvar flow diameter) with calculation of a Doppler ratio relating these two measurements, expressed as a percentage of broadening. Diagnostic value was compared for both procedures. RESULTS: There was no significant difference in age, mitral valve areas, or haemodynamics for the two groups. Mean values (SD) were: echo score: group 1, 9.83 (1.26) v group 2, 10.8 (8.1), NS; Doppler ratio %: group 1, 44 (24) v group 2, 12 (21) (P &lt; 0.001); control group: 69 (15). The per cent diagnostic value for an open heart commissurotomy of respective cut off points was: Doppler ratio &gt; 25% (range 71% to 87%); echo score &lt; 10 (range 50% to 75%). CONCLUSIONS: The new Doppler ratio diagnostic value agreed better with surgical management, repair or prosthesis, in this study. Thus, it appears to better reflect the subvalvar involvement and changes in kinetics than the echo score alone. This easy Doppler method might become a routine examination for follow up of patients with open heart commissurotomy, to avoid performing repeated transoesophageal echocardiography.<\/jats:p>","DOI":"10.1136\/hrt.75.5.486","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:46:00Z","timestamp":1190137560000},"page":"486-491","source":"Crossref","is-referenced-by-count":2,"title":["Colour doppler valvar and subvalvar flow diameter imaging versus echo score in mitral stenosis: comparison with type of surgery."],"prefix":"10.1136","volume":"75","author":[{"given":"C.","family":"Veyrat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Pellerin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Sainte Beuve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Larrazet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Kalmanson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Witchitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/0002-9149(91)90508-I","article-title":"Assessment of the mitral valve splitability score by transthoracic and transesophageal echocardiography","volume":"68","author":"Marwick, T.H.; Torelli, J.; Obarski, T.; Casale, P.N.; Stewart, W.J.","year":"1991","unstructured":"Marwick TH, Torelli J, Obarski T, Casale PN, Stewart WJ. Assessment of the mitral valve splitability score by transthoracic and transesophageal echocardiography. Am Jf Cardiol 1991;68:1106-7.","journal-title":"Am Jf Cardiol"},{"key":"ref_2","first-page":"9","article-title":"Anatomic and functional evaluation of pure and associated mitral stenoses using the echo-Doppler scanner technique","volume":"1983","author":"Veyrat, C.; Villemot, J.P.; Manin, J.P.; Cabrol, C.; Kalmanson, D.","unstructured":"Veyrat C, Villemot JP, Manin JP, Cabrol C, Kalmanson D. Anatomic and functional evaluation of pure and associated mitral stenoses using the echo-Doppler scanner technique. Ultrasound Med Biol 1983:9:1-17.","journal-title":"Ultrasound Med Biol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/000331979004100502","article-title":"Quantification of left-sided valvular stenoses by color-Doppler imaging of jets","volume":"41","author":"Veyrat, C.; Sainte Beuve, D.; Gourtchiglouian, C.; Legeais, S.; Kalmanson, D.","year":"1990","unstructured":"Veyrat C, Sainte Beuve D, Gourtchiglouian C, Legeais S, Kalmanson D. Quantification of left-sided valvular stenoses by color-Doppler imaging of jets. Angiology 1990;41:352-63.","journal-title":"Angiology"},{"key":"ref_4","first-page":"258","article-title":"Respective timing of maximal color Doppler jet areas and of peak velocity of jets in leftsided valvular jets. YAm Soc Echocardiogr","volume":"4","author":"Veyrat, C.; El Yafi, W.; Gourtchiglouian, C.; Bas, S.; Sainte Beuve, D.; Kalmanson, D.","year":"1991","unstructured":"Veyrat C, El Yafi W, Gourtchiglouian C, Bas S, Sainte Beuve D, Kalmanson D. Respective timing of maximal color Doppler jet areas and of peak velocity of jets in leftsided valvular jets. YAm Soc Echocardiogr 1991;4:258-66."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.2307\/4586294","article-title":"Statistical problems in assessing methods of medical diagnosis, with special reference to X-ray techniques","volume":"62","author":"Yerushalmy, J.","year":"1947","unstructured":"Yerushalmy J. Statistical problems in assessing methods of medical diagnosis, with special reference to X-ray techniques. Public Health Rep 1947;62:1432-49.","journal-title":"Public Health Rep"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1016\/0735-1097(90)90260-V","article-title":"Influence of orifice geometry and flow rate on effective valve area: an in vitro study","volume":"15","author":"Flachskampf, F.A.; Weyman, A.E.; Guerrero, J.L.; Thomas, J.D.","year":"1990","unstructured":"Flachskampf FA, Weyman AE, Guerrero JL, Thomas JD. Influence of orifice geometry and flow rate on effective valve area: an in vitro study. J7Am Coil Cardiol 1990;15: 1173-80.","journal-title":"J7Am Coil Cardiol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/0735-1097(90)90593-E","article-title":"Aortic valve morphology: an important in vitro determinant of proximal regurgitant jet width by Doppler flow mapping","volume":"16","author":"Taylor, A.L.; Eichhorn, E.J.; Brickner, M.E.; Eberhard, R.C.","year":"1990","unstructured":"Taylor AL, Eichhorn EJ, Brickner ME, Eberhard RC. Aortic valve morphology: an important in vitro determinant of proximal regurgitant jet width by Doppler flow mapping. JAm Coll Cardiol 1990;16:405-12.","journal-title":"JAm Coll Cardiol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/S0735-1097(88)80045-7","article-title":"Echocardiographic evaluation of mitral valve structure and function in patients followed for at least 6 months after percutaneous balloon mitral valvuloplasty","volume":"12","author":"Abascal, V.M.; Wilkins, G.T.; Choong, C.Y.; Thomas, J.D.; Palacios, I.F.; Block, P.C.","year":"1988","unstructured":"Abascal VM, Wilkins GT, Choong CY, Thomas JD, Palacios IF, Block PC, et al. Echocardiographic evaluation of mitral valve structure and function in patients followed for at least 6 months after percutaneous balloon mitral valvuloplasty. JAm Coll Cardiol 1988;12:606-15.","journal-title":"JAm Coll Cardiol"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/0002-8703(92)90274-Y","article-title":"Influence of mitral valve morphology on mitral balloon commissurotomy: immediate and sixmonth results from the NHLBI balloon valvuloplasty registry","volume":"124","author":"Reid, C.L.; Otto, C.M.; Davis, K.B.; Labovitz, A.; Kisslo, K.B.; McKay, C.R.","year":"1992","unstructured":"Reid CL, Otto CM, Davis KB, Labovitz A, Kisslo KB, McKay CR. Influence of mitral valve morphology on mitral balloon commissurotomy: immediate and sixmonth results from the NHLBI balloon valvuloplasty registry. Am HeartJ 1992;124:657-65.","journal-title":"Am HeartJ"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1152\/ajplegacy.1963.205.2.385","article-title":"Chordae tendinae tension","volume":"205","author":"Salisbury, P.F.; Cross, C.E.; Rieben, P.A.","year":"1963","unstructured":"Salisbury PF, Cross CE, Rieben PA. Chordae tendinae tension. Am J Physiol 1963;205:385-92.","journal-title":"Am J Physiol"},{"key":"ref_11","first-page":"43","article-title":"Reliability and reproducibility of two dimensional echocardiographic measurement of the stenotic mitral orifice area","volume":"1979","author":"Martin, R.P.; Rakowski, H.; Kleiman, J.H.; Beaver, W.; London, E.; Popp, R.L.","unstructured":"Martin RP, Rakowski H, Kleiman JH, Beaver W, London E, Popp RL. Reliability and reproducibility of two dimensional echocardiographic measurement of the stenotic mitral orifice area. Am J Cardiol 1979:43:560-8.","journal-title":"Am J Cardiol"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.75.5.486","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T20:44:49Z","timestamp":1760733889000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.75.5.486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,5]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[1996,5,1]]},"published-print":{"date-parts":[[1996,5]]}},"alternative-id":["10.1136\/hrt.75.5.486"],"URL":"https:\/\/doi.org\/10.1136\/hrt.75.5.486","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"type":"print","value":"1355-6037"},{"type":"electronic","value":"1468-201X"}],"subject":[],"published":{"date-parts":[[1996,5]]}}}