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Valvar regurgitation in normal children: Is it clinically significant?

Published online by Cambridge University Press:  19 August 2008

Sandra da Silva Mattos ,
Rossana Severi ,
Catarina Vasconcelos Cavalcanti ,
Monica da Fonte Freire  and
Djair Brindeiro Filho
Sandra da Silva Mattos*
Affiliation:
Instituto do Coração de Pernambuco, Recife
Rossana Severi
Affiliation:
Instituto do Coração de Pernambuco, Recife
Catarina Vasconcelos Cavalcanti
Affiliation:
the Serviço de Ecocardiografia do Recife, Recife
Monica da Fonte Freire
Affiliation:
the Serviço de Ecocardiografia do Recife, Recife
Djair Brindeiro Filho
Affiliation:
the Serviço de Ecocardiografia do Recife, Recife
*
Dr. Sandra S. Mattos, Instituto do Coração de Pernambuco, Avenida Portugal, 163, Recife, 50.010, Brazil. Tel. 081-231-5968; Fax. 081-421-2473.
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Summary

This study aimed to assess the prevalence of “silent” valvar regurgitation in healthy Brazilian children; to determine whether variations in the gain settings of the machine interfered with its documentation; and to compare Doppler color flow mapping with the pulsed wave Doppler. Twenty-five healthy children were selected randomly. Echocardiographic equipment used was ALOKA 870. Fixed parameters were 3.5 MHz transducer, 400 Hz filter, reject of 7/14 and aperture of 30/80. Variable parameters were Doppler color flow mapping and pulsed wave Doppler gains. A protocol for evaluation of each cardiac valve was developed. Regurgitation was noted in 93% for the pulmonary valve, 74% for the tricuspid valve and 27% for the mitral valve. In the aortic valve, jets suggestive of mild valvar regurgitation were observed with the Doppler color flow mapping technique in two children but these findings were not corroborated by pulsed wave Doppler. Only in the aortic valve were findings from Doppler color flow mapping not in agreement with those from pulsed wave Doppler. Variations in the settings for gain did not interfere significantly in the documentation of regurgitation. Inter-observer variations were not significant (two independent operators). The clinical implications of these findings are yet to be established. Labeling these regurgitant jets as “normal” may be oversimplifying their meaning and perhaps overlooking the possibility of predisposition to endocarditis or progression of the valvar abnormality. Conversely, labeling them as “abnormal” can generate a more serious problem, which is that of iatrogenic heart disease. Prospective follow-up studies should be carried out in these subjects.

Keywords

Echocardiographynormal childrenvalvar regurgitation
Type
Original Articles
Information
Cardiology in the Young , Volume 2 , Issue 3 , July 1992 , pp. 291 - 297
Copyright
Copyright © Cambridge University Press 1992

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