Purpose. Volume-rendered images of the mitral valve apparatus have enabled visualization of the MV leaflets, orifice, and submitral apparatus in a manner that is not possible using conventional 2-dimensional echocardiography. We attempted to quantitate color-flow jets in ischemic mitral regurgitation (MR) by real-time three-dimensional (3D) echocardiography and compared the results with conventional two-dimensional (2D) color-Doppler methods. Method. Thirty-one patients with ischemic MR were studied by 2D color-Doppler echocardiography to obtain jet area (2D-JA), left atrium (LA) area and vena contracta diameter (2D-VCD) measurements. The same parameters (jet volume, LA volume, vena contracta area) were analyzed offline from color-flow jets obtained using real-time 3D echocardiography (3D-JV, 3D-VCA). Results. 27 patients (87%) had sufficient data quality for analysis. Comparison of 2D-JA/LA ratios tended to be larger in 4-chamber than 2-chamber view but were not statistically significant. The 3D-JV/LV ratio was smaller than the 2D-JA/LA ratio (p< .001). Manually traced 3D MR volumes had good agreement when compared with proximal isovelocity surface area–derived volumes (r = 0.87, y = 0.4x + 7.4) with minimal underestimation of volumes (6 ml) but wide limits of agreement (29 ml). 3D-VCA and 2D-VCD correlated significantly with effective regurgitant orifice area derived by volumetric Doppler method (r = 0.87, p < 0.001 and r = 0.64, p < 0.005, respectively). Relation between 3D-VCA and Doppler effective regurgitant orifice area had a linear regression equation close the line of identity. Conclusions. Quantitative methods using 3D echocardiography correlated well with 2D methods. 3D volume-derived jets were slightly smaller than 2D area-derived jets. Correlation with volumetric Doppler method was stronger for 3D-VCA than that for 2D-VCD. In ischemic MR 3D-echocardiography may overcome underestimation or overestimation caused by jet eccentricity.
Three-dimensional color Doppler flow assessment of ischemic mitral regurgitation / Vitarelli, Antonino; D'Orazio, Simona; Nguyen, BICH LIEN; Iorio, G; Battaglia, Daniela; Caranci, Fiorella; Padella, V; Capotosto, Lidia; Alessandroni, L; Barillà, F.. - In: EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY. - ISSN 1525-2167. - STAMPA. - 11 (Suppl 2):(2010), p. ii62.
Three-dimensional color Doppler flow assessment of ischemic mitral regurgitation
VITARELLI, Antonino;D'ORAZIO, SIMONA;NGUYEN, BICH LIEN;BATTAGLIA, DANIELA;CARANCI, FIORELLA;CAPOTOSTO, LIDIA;
2010
Abstract
Purpose. Volume-rendered images of the mitral valve apparatus have enabled visualization of the MV leaflets, orifice, and submitral apparatus in a manner that is not possible using conventional 2-dimensional echocardiography. We attempted to quantitate color-flow jets in ischemic mitral regurgitation (MR) by real-time three-dimensional (3D) echocardiography and compared the results with conventional two-dimensional (2D) color-Doppler methods. Method. Thirty-one patients with ischemic MR were studied by 2D color-Doppler echocardiography to obtain jet area (2D-JA), left atrium (LA) area and vena contracta diameter (2D-VCD) measurements. The same parameters (jet volume, LA volume, vena contracta area) were analyzed offline from color-flow jets obtained using real-time 3D echocardiography (3D-JV, 3D-VCA). Results. 27 patients (87%) had sufficient data quality for analysis. Comparison of 2D-JA/LA ratios tended to be larger in 4-chamber than 2-chamber view but were not statistically significant. The 3D-JV/LV ratio was smaller than the 2D-JA/LA ratio (p< .001). Manually traced 3D MR volumes had good agreement when compared with proximal isovelocity surface area–derived volumes (r = 0.87, y = 0.4x + 7.4) with minimal underestimation of volumes (6 ml) but wide limits of agreement (29 ml). 3D-VCA and 2D-VCD correlated significantly with effective regurgitant orifice area derived by volumetric Doppler method (r = 0.87, p < 0.001 and r = 0.64, p < 0.005, respectively). Relation between 3D-VCA and Doppler effective regurgitant orifice area had a linear regression equation close the line of identity. Conclusions. Quantitative methods using 3D echocardiography correlated well with 2D methods. 3D volume-derived jets were slightly smaller than 2D area-derived jets. Correlation with volumetric Doppler method was stronger for 3D-VCA than that for 2D-VCD. In ischemic MR 3D-echocardiography may overcome underestimation or overestimation caused by jet eccentricity.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
