From the Guidelines
The mitral valve assessment shows normal structure and function, with no significant stenosis or regurgitation that would require intervention, as evidenced by a peak velocity of 1.2 m/s, peak gradient of 6 mmHg, mean gradient of 2 mmHg, and a mitral valve area of 3.6 cm² 1. The peak velocity is within normal limits, typically less than 1.3 m/s. The peak and mean gradients are also within normal range, with a normal mean gradient less than 5 mmHg.
Key Findings:
- Peak velocity: 1.2 m/s
- Peak gradient: 6 mmHg
- Mean gradient: 2 mmHg
- Mitral valve area: 3.6 cm²
- Regurgitation: trivial, which is clinically insignificant and commonly found in normal hearts, as supported by the European Association of Cardiovascular Imaging guidelines for grading the severity of primary mitral regurgitation 1. The mitral valve area, calculated using the pressure half-time method, is normal, indicating no stenosis.
Clinical Implications:
- No significant stenosis or regurgitation
- Trivial regurgitation is a common finding in healthy individuals and typically doesn't progress or require treatment
- Normal mitral valve parameters suggest adequate left ventricular filling during diastole without obstruction to blood flow from the left atrium to the left ventricle. According to the guidelines, the grading of severity of organic mitral regurgitation classifies regurgitation as mild, moderate, or severe, and subclassifies the moderate regurgitation group into ‘mild-to-moderate’ and ‘moderate-to-severe’ 1. However, in this case, the trivial regurgitation is not significant enough to warrant further classification or intervention.
From the Research
Mitral Valve Structure and Function
- The mitral valve has a normal peak velocity of 1.2 m/s, with no stenosis and a peak gradient of 6 mmHg, and a mean gradient of 2 mmHg 2, 3.
- The mitral valve area (MVA) is calculated using the pressure half-time method, with an area of 3.6 cm² 4.
- Trivial regurgitation is present, indicating some leakage of the valve, but it is not significant 2, 3.
Mitral Regurgitation
- Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, allowing blood to flow back into the left atrium 2, 3.
- MR can be primary (organic) or secondary (functional), depending on the underlying cause 2.
- The severity of MR can be assessed using quantitative measures, such as echocardiography 2, 4.
- Treatment options for MR include percutaneous mitral valve repair, mitral valve replacement, and minimally invasive surgery 5.
Diagnostic Techniques
- Echocardiography is a commonly used imaging technique for evaluating mitral valve anatomy and function 4, 6.
- Stress echocardiography can be used to assess asymptomatic patients with significant mitral stenosis or symptomatic patients with mild disease at rest 6.
- Three-dimensional echocardiography and computed tomography can provide high spatial resolution images of the mitral valve and surrounding structures 4.
- Cardiac magnetic resonance can accurately assess mitral valve anatomy and function, and is considered the method of reference for quantifying mitral flow 4.