Mitral valve E point to septal separation as an index of left ventricular function in chronic aortic regurgitation
Elbaum, D.M.; Wolfson, P.M.; Braunstein, D.B.; Haspel, L.U.; Smith, C.R.
Journal of the American Osteopathic Association 82(9): 649-653
1983
ISSN/ISBN: 0098-6151 PMID: 6863040 Document Number: 213504
Mitral valve E point to septal separation (EPSS) is a simple, noninvasive index of left ventricular function in many cardiac diseases. It was not demonstrated to be of similar value in conditions affecting anterior mitral valve leaflet motion, such as chronic aortic regurgitation (AR). EPSS was compared to single-plane angiographic ejection fraction (EFA) in 18 patients with chronic AR to determine its usefulness. Patients were divided into 2 groups according to EPSS. Group 1 (9 patients) had normal EPSS, .ltoreq. 6 mm (mean 3.2 .+-. 0.9 SEM [SE of the mean]). Group 2 (9 patients) had an increased EPSS, > 6 mm (mean 11.5 .+-. 1.1 SEM). A significant negative correlation (r = -0.78, P < 0.001) was found between EPSS and EFA. The mean EFA for group 1 was 75.6% .+-. 10, and the mean EFA for group 2 was 54.2% .+-. 11.4. This was statistically significant. Three patients in group 2 had a normal EFA. In this study a normal EPSS (.ltoreq. 6 mm) was highly predictive of a normal EFA (.gtoreq. 55%) in patients with chronic aortic regurgitation. An increased EPSS, although highly sensitive (100%) is less specific (75%) for a decreased EFA.