Mitral / aortic flow velocity time integral ratio; its diagnostic power for identification of haemodynamically signification mitral regurgitation

This study aimed to evaluate the diagnostic power of the simple Doppler index of the mitral/aortic flow velocity time integral [VTI] ratio to identify subjects with haemodynamically significant MR compared with three valid quantitative echocardiographic methods [regurgitant volume, fraction and orifice area]. This work studied 30 patients with MR of different grades and etiologies and 10 healthy volunteers as a control group. All were subjected to complete history taking and clinical examination, ECG, plain X-ray, complete echocardiographic and Doppler examination of the heart and determination of the severity of MR by pulsed wave Doppler [PWD]. The study found that the mitral/aortic flow VTI ratio has accepted sensitivity, specificity, P predictive value and total accuracy in quantitation of the severity of MR compared with the quantitative 2D Doppler methods used for quantitation of the severity of MR. Also, it has the advantage of being a very simple method because in the presence of MR, if the mitral/aortic flow VTI ratio is [0.82 +/- 0.12] the MR is mild, if the ratio is [1.11 +/- 0.20] the MR is moderate and if the ratio is [1.39 +/- 0.29] the MR is severe. It was concluded that the mitral/aortic flow VTI ratio has the diagnostic power to identify subjects with hacmodynamically significant MR. Also, it is a simple and accurate method that can be used for grading of MR, sensitive and valid with accepted total accuracy

Prediction of servere angiographic coronary artery disease through multivariable probability scoring system based on clinical and exercise test data

This study included 120 patients [98 males and 22 females, their ages ranged from 24-70 years] with suspected coronary artery disease. All candidates were subjected to complete history taking and thorough clinical examination including blood cholesterol level, resting 12-lead surface ECG, exercise stress test and coronary angiography. The patients were randomly divided into a training set and a testing set. The training set included 95 patients [80 males and 15 females], which were divided into 2 groups according to the coronary angiographic result. Group I included patients with significant coronary artery disease defined as >70% narrowing in LAD, circumflex artery, right coronary artery or their major branches or 50% narrowing in the left main coronary artery. The test set included 25 patients [18 males and 7 females with an age ranged from 35-61 years, with a mean age of 48.2 +/- 8 years]. Group I and II were compared as regards the different clinical, exercise and hemodynamic variables and introduced those variables into a step-wise logistic regression analysis for the development of the pretest and post test equations for predicting the presence of CAD in the test set of patients. The study showed that the equation can discriminate the accuracy for the detection of patients with severe coronary artery disease in a given group. It can be used for detecting patients with high probability of coronary artery disease with accepted accuracy, sensitivity, specificity and predictive value compared with other equations. It may be helpful for the detection of patients with coronary artery disease and referring them to the appropriate level of investigation and treatment with superior sensitivity than that of the standard criteria of exercise stress test. So, it will be of a great help in referring the patient to the appropriate level of evaluation and treatment, which will result in selective resource use [only the high-risk patient to be referred to expensive and invasive procedures] and cost saving