Document Detail


In vitro validation of real-time three-dimensional color Doppler echocardiography for direct measurement of proximal isovelocity surface area in mitral regurgitation.
MedLine Citation:
PMID:  17493476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The 2-dimensional (2D) color Doppler (2D-CD) proximal isovelocity surface area (PISA) method assumes a hemispheric flow convergence zone to estimate transvalvular flow. Recently developed 3-dimensional (3D)-CD can directly visualize PISA shape and surface area without geometric assumptions. To validate a novel method to directly measure PISA using real-time 3D-CD echocardiography, a circulatory loop with an ultrasound imaging chamber was created to model mitral regurgitation (MR). Thirty-two different regurgitant flow conditions were tested using symmetric and asymmetric flow orifices. Three-dimensional-PISA was reconstructed from a hand-held real-time 3D-CD data set. Regurgitant volume was derived using both 2D-CD and 3D-CD PISA methods, and each was compared against a flow-meter standard. The circulatory loop achieved regurgitant volume within the clinical range of MR (11 to 84 ml). Three-dimensional-PISA geometry reflected the 2D geometry of the regurgitant orifice. Correlation between the 2D-PISA method regurgitant volume and actual regurgitant volume was significant (r(2) = 0.47, p <0.001). Mean 2D-PISA regurgitant volume underestimate was 19.1 +/- 25 ml (2 SDs). For the 3D-PISA method, correlation with actual regurgitant volume was significant (r(2) = 0.92, p <0.001), with a mean regurgitant volume underestimate of 2.7 +/- 10 ml (2 SDs). The 3D-PISA method showed less regurgitant volume underestimation for all orifice shapes and regurgitant volumes tested. In conclusion, in an in vitro model of MR, 3D-CD was used to directly measure PISA without geometric assumption. Compared with conventional 2D-PISA, regurgitant volume was more accurate when derived from 3D-PISA across symmetric and asymmetric orifices within a broad range of hemodynamic flow conditions.
Authors:
Stephen H Little; Stephen R Igo; Bahar Pirat; Marti McCulloch; Craig J Hartley; Yukihiko Nosé; William A Zoghbi
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Publication Detail:
Type:  Journal Article; Validation Studies     Date:  2007-04-09
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-11     Completed Date:  2007-08-02     Revised Date:  2012-05-11    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1440-7     Citation Subset:  AIM; IM    
Affiliation:
Methodist DeBakey Heart Center, Houston, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity*
Computer Systems*
Echocardiography, Doppler, Color / methods*
Echocardiography, Three-Dimensional / methods*
Equipment Design
Humans
Image Interpretation, Computer-Assisted
Image Processing, Computer-Assisted
Linear Models
Mitral Valve Insufficiency / physiopathology*,  ultrasonography*
Observer Variation
Research Design
Grant Support
ID/Acronym/Agency:
R01 HL022512/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Am J Cardiol. 2007 Nov 1;100(9):1495-6   [PMID:  17950817 ]

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


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