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Patients With Normal Twodimensional Echocardiograms (8)

These data are particularly important, especially considering the increasing diffusion of Doppler echocardiography into community practice. The finding that 94 percent of “normal” subjects have valvular regurgitation of at least one valve raises issues with regard to patient well-being, employability, insurability, and endocarditis prophylaxis recommendations. In fact, recent data from Olmsted County, Minnesota, indicated that Doppler-detected mitral regurgitation had major impact on clinical practice, at least regarding the provision of endocarditis prophylaxis recommendations, in patients with structurally normal 2D echocardiograms as well as those with mitral valve prolapse.
Since echocardiography is noninvasive and relatively inexpensive, many physicians (cardiologists and noncardiologists) regularly use and perform this technique. Indications for this procedure, however, have been a subject of controversy, as has the level of training necessary for valid examinations and their interpretation. In addition, during the past decade there has been an explosive growth in echocardiographic and Doppler technology.
The detection of valvular regurgitation depends on the quality of the Doppler echocardiographic equipment as well as the skill, time, and effort given by the technician and/or physician operator. The finding of a somewhat higher prevalence of valvular regurgitation in the present study compared with that reported by others takes into account the above factors but is probably mosdy related to the combination of all Doppler modalities (color-flow, continuous-wave, and pulsed-wave Doppler) used in the current study.

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