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Patients With Normal Twodimensional Echocardiograms (4)

Fifty studies were reinterpreted by one echocardiographer (C.J.L.), who was blinded to the original interpretation, to determine intraobserver and interobserver reproducibility for prevalence of mitral and tricuspid regurgitation. Of these 50 studies, 25 were originally interpreted by the same echocardiographer and the others by 1 of 2 different staff echocardiographers. The intraobserver and interobserver reproducibilities for mitral regurgitation (94 percent and 95 percent, respectively) and tricuspid regurgitation (92 percent and 95 percent, respectively) were both excellent. The small numbers involved did not allow for reliable determination of reproducibility of moderate mitral and tricuspid regurgitation.
Aortic Regurgjttation: Semiquantitation of aortic regurgitation was done by a composite analysis of three Doppler methods, as described elsewhere by Freeman and colleagues.u (1) Short-axis and long-axis area and height of the aortic regurgitant jet optimized by Doppler color-flow mapping were correlated with the corresponding area and height of the immediate subvalvular left ventricular outflow tract (LVOT). Similar to the method of Perry et al,u the ratio of the aortic regurgitant jet area/LVOT area (parasternal short-axis view) and the ratio of aortic regurgitation jet height/LVOT height (parasternal long-axis view) were semiquantified so that ^0.25=mild, 0.26 to 0.60=moderate, and ^0.60=severe. Barely detectable aortic regurgitation (<0.05 to 0.10) was defined as trival. (2) Using continuous-wave Doppler, the aortic regurgitant pressure half-time was analyzed, and aortic regurgitation was classified as mild if the diastolic pressure half-time was ^600 ms, moderate if it was 251 to 599 ms, and severe if it was ^250 ms.

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