From the Guidelines
The mitral valve assessment shows normal structure and function, with no significant stenosis or regurgitation that would require intervention or follow-up, as evidenced by a peak velocity of 1.2 m/s, peak gradient of 6 mmHg, and mean gradient of 2 mmHg, all of which are within normal limits 1. The peak velocity is 1.2 m/s, which falls within normal limits, and the peak gradient is 6 mmHg and mean gradient is 2 mmHg, both of which are normal.
- The mitral valve area is 3.6 cm², which is well above the normal threshold, indicating no stenosis, as confirmed by the "None" assessment for stenosis.
- There is only trivial regurgitation, which is clinically insignificant and often considered a normal variant present in many healthy individuals, as supported by the guidelines for grading the severity of primary MR, which classify regurgitation as mild, moderate, or severe, with trivial regurgitation not meeting the criteria for mild MR 1.
- The pressure half-time method was used to calculate the valve area, which is a standard echocardiographic technique. Overall, this mitral valve shows normal hemodynamics with no significant stenosis or regurgitation that would require intervention or follow-up, and trivial regurgitation is common and physiologic, representing small amounts of blood that flow backward through the valve during systole but have no clinical significance or impact on cardiac function, as indicated by the guidelines for the echocardiographic assessment of native valvular regurgitation 1.
From the Research
Mitral Valve Structure and Function
- The mitral valve is a complex structure composed of several components, each of which can be affected by a variety of diseases, resulting in mitral regurgitation 2
- The normal peak velocity of the mitral valve is 1.2 m/s, and the mean pressure gradient is 6 mmHg, with a trivial regurgitation and an area of 3.6 cm²
Mitral Regurgitation
- Mitral regurgitation (MR) is increasingly prevalent and poses an important public health problem, with primary (organic) MR due to intrinsic valvular disease, and secondary (functional) MR due to disruption of an otherwise normal mitral apparatus because of abnormal ventricular geometry 3
- The severity of MR can be assessed using quantitative measures, and careful follow-up is paramount in the management of MR to accomplish timely surgical intervention 3
- Mitral valve repair is preferable to valve replacement, and the optimal timing of surgery for asymptomatic patients with chronic severe MR remains controversial 3
Diagnosis and Treatment
- Echocardiography is the most useful noninvasive technique for evaluating patients with mitral regurgitation, and Doppler echocardiography can establish the diagnosis of mitral regurgitation in difficult cases 2
- Cardiac catheterization and angiography are usually reserved for the patient being considered for valvular surgery, and medical therapy consists of digitalis, diuretics, and vasodilators for symptomatic patients 2
- Percutaneous valve interventions for MR are being extensively investigated, and valve repair (percutaneous mitral commissurotomy for mitral stenosis and valvuloplasty for mitral regurgitation) might be possible depending on the anatomy of the valvular and subvalvular apparatus 4
Exercise Tolerance and Mitral Regurgitation
- Mitral regurgitation impairs exercise tolerance independent of left ventricular ischemia, dysfunction, and clinical indexes, and the magnitude of exercise impairment parallels the severity of MR 5
- Both functional and nonfunctional MR subgroups demonstrate significantly decreased effort tolerance in relation to MR severity, and functional MR predicts reduced metabolic equivalent of task-based effort independent of MR severity 5