Document Detail


Direct measurement of multiple vena contracta areas for assessing the severity of mitral regurgitation using 3D TEE.
MedLine Citation:
PMID:  22789934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to determine whether direct measurement of multiple-jet vena contracta (VC) areas by real-time 3-dimensional (3D) transesophageal echocardiography is an accurate method for measuring the severity of mitral regurgitation (MR) in patients with multiple MR jets.
BACKGROUND: Because of the conflicting requirements of Doppler and imaging physics, measuring VC using 2-dimensional (2D) echocardiography is a difficult procedure for assessing MR severity. A real-time 3D echocardiographic measurement of the VC area has been validated in a single jet of MR, but the applicability of this method for multiple jets is unknown.
METHODS: Two-dimensional and 3D transesophageal echocardiography was performed in 60 patients with multiple functional MR jets. MR severity was assessed quantitatively using the effective regurgitant orifice area derived from 3D left ventricular volume and thermodilution data (EROAstd). Manual tracings of multiple 3D VC areas in a cross-sectional plane through the VC were obtained, and the sum of the areas was compared using EROAstd. Similarly, 2D measurement of VC diameter was obtained from a 2D transesophageal echocardiographic view to optimize the largest legion size in each jet. All VC diameters were summed and compared with EROAstd.
RESULTS: The correlation of the sum of the multiple 3D VC areas with EROAstd (r = 0.90, p < 0.01) was higher than that of the sum of the multiple 2D VC diameters (r = 0.56, p < 0.01), particularly with MR degrees greater than mild (r = 0.80, p < 0.01 vs. r = 0.05, p = 0.81) and in cases of 3 or more regurgitant jets (r = 0.91, p < 0.01 vs. r = 0.46, p = 0.05).
CONCLUSIONS: Direct measurement of multiple VC areas using 3D transesophageal echocardiography allows for assessing MR severity in patients with multiple jets, particularly for MR degrees greater than mild and in cases of more than 2 jets, for which geometric assumptions may be challenging.
Authors:
Eiichi Hyodo; Shinichi Iwata; Aylin Tugcu; Kotaro Arai; Kenei Shimada; Takashi Muro; Junichi Yoshikawa; Minoru Yoshiyama; Linda D Gillam; Rebecca T Hahn; Marco R Di Tullio; Shunichi Homma
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  5     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-13     Completed Date:  2012-12-03     Revised Date:  2013-08-06    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  669-76     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiology Department, Columbia University Medical Center, New York, New York 10032, USA. ehyodo47@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Echocardiography, Doppler, Color* / instrumentation
Echocardiography, Three-Dimensional* / instrumentation
Echocardiography, Transesophageal* / instrumentation
Equipment Design
Feasibility Studies
Female
Humans
Male
Mitral Valve / physiopathology,  ultrasonography*
Mitral Valve Insufficiency / physiopathology,  ultrasonography*
Models, Cardiovascular
New York City
Observer Variation
Predictive Value of Tests
Reproducibility of Results
Severity of Illness Index
Thermodilution
Transducers
Comments/Corrections
Comment In:
JACC Cardiovasc Imaging. 2013 Jun;6(6):744   [PMID:  23764102 ]
JACC Cardiovasc Imaging. 2012 Jul;5(7):677-80   [PMID:  22789935 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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