Which method is used to assess mitral stenosis severity from Doppler-derived gradients?

Which method is used to assess mitral stenosis severity from Doppler-derived gradients?

• A. Continuity equation
• B. Planimetry
• C. RVSP
• D. Mean gradient

Answer: (D)

Mitral stenosis is graded by how much resistance the narrowed mitral valve offers to diastolic flow, which Doppler can quantify by converting flow velocity into a pressure difference across the valve. The mean transvalvular gradient represents the average pressure drop throughout diastole, so it captures the overall obstruction rather than a single instant of peak velocity. This makes it a more reliable and clinically meaningful measure of severity, especially since heart rate and diastolic filling time can shift peak values but have less effect on the average gradient. In practice, the mean gradient derived from the velocity profile (using ΔP = 4V^2) is the standard way to assess severity from Doppler gradients.

Mitral stenosis is graded by how much resistance the narrowed mitral valve offers to diastolic flow, which Doppler can quantify by converting flow velocity into a pressure difference across the valve. The mean transvalvular gradient represents the average pressure drop throughout diastole, so it captures the overall obstruction rather than a single instant of peak velocity. This makes it a more reliable and clinically meaningful measure of severity, especially since heart rate and diastolic filling time can shift peak values but have less effect on the average gradient. In practice, the mean gradient derived from the velocity profile (using ΔP = 4V^2) is the standard way to assess severity from Doppler gradients.