• Gaurav Kumar Gogoi, Soumi Das, Chaitali Sen, and Avijit Hazra.
• Department of Cardiac Anaesthesiology, I.P.G.M.E&R and S.S.K.M. Hospital, Kolkata, India.
• J. Cardiothorac. Vasc. Anesth. 2023 Jan 1; 37 (1): 162216-22.

ObjectivesTo evaluate mitral-aortic flow velocity integral ratio (MAVIR) as an echocardiographic tool to differentiate between severe and nonsevere mitral regurgitation (MR), compared with regurgitant volume (RVol) and effective regurgitant orifice area (EROA), with subgroup analysis in patients with calcific mitral valve, both by transthoracic (TTE) and transesophageal (TEE) echocardiography. Also, whether MAVIR can be used as a screening tool for severe MR.DesignProspective, cross-sectional, observational.SettingCardiac operating room of a tertiary-care hospital.ParticipantsOne hundred adult patients with chronic mitral regurgitation with at least mild MR by two-dimensional Doppler and with absence of mitral stenosis, aortic valve disease, and rhythm other than sinus scheduled for cardiac surgery. The subgroup (n = 24) consisted specifically of patients with a calcific mitral valve.InterventionsPreinduction TTE and postinduction TEE in the operating room.Measurements And ResultsMAVIR, RVol, and EROA were measured in all patients both by TTE and TEE. Cohen's kappa statistics was employed to quantify concordance among RVol, EROA, and MAVIR. Diagnostic indices of MAVIR toward diagnosis of severe MR also were quantified. The results showed a strong agreement, in differentiating severe from nonsevere MR, between MAVIR and both RVol and EROA in the whole cohort (n = 100) and the subgroup (n = 24), both by TTE and TEE. Diagnostic indices were high for MAVIR compared with RVol and EROA in detecting severe MR, both by TTE and TEE.ConclusionMAVIR may be used as an echocardiographic tool to differentiate between severe and nonsevere MR, even in patients with calcific valves. It also can be used to screen patients for severe MR.Copyright © 2022 Elsevier Inc. All rights reserved.

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