Document Detail


Quantitative assessment of mitral regurgitation: comparison between three-dimensional transesophageal echocardiography and magnetic resonance imaging.
MedLine Citation:
PMID:  20810848     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: quantification of mitral regurgitation severity with 2-dimensional (2D) imaging techniques remains challenging. The present study compared the accuracy of 2D transesophageal echocardiography (TEE) and 3-dimensional (3D) TEE for quantification of mitral regurgitation, using MRI as the reference method.
METHODS AND RESULTS: two-dimensional and 3D TEE and cardiac MRI were performed in 30 patients with mitral regurgitation. Mitral effective regurgitant orifice area (EROA) and regurgitant volume (Rvol) were estimated with 2D and 3D TEE. With 3D TEE, EROA was calculated using planimetry of the color Doppler flow from en face views and Rvol was derived by multiplying the EROA by the velocity time integral of the regurgitant jet. Finally, using MRI, mitral Rvol was quantified by subtracting the aortic flow volume from left ventricular stroke volume. Compared with 3D TEE, 2D TEE underestimated the EROA by a mean of 0.13 cm(2). In addition, 2D TEE underestimated the Rvol by 21.6% when compared with 3D TEE and by 21.3% when compared with MRI. In contrast, 3D TEE underestimated the Rvol by only 1.2% when compared with MRI. Finally, one third of the patients in grade 1 and ≥50% of the patients in grade 2 and 3, as assessed with 2D TEE, would have been upgraded to a more severe grade, based on the 3D TEE and MRI measurements.
CONCLUSIONS: quantification of mitral EROA and Rvol with 3D TEE is feasible and accurate as compared with MRI and results in less underestimation of the Rvol as compared with 2D TEE.
Authors:
Miriam Shanks; Hans-Marc J Siebelink; Victoria Delgado; Nico R L van de Veire; Arnold C T Ng; Allard Sieders; Joanne D Schuijf; Hildo J Lamb; Nina Ajmone Marsan; Jos J M Westenberg; Lucia J Kroft; Albert de Roos; Jeroen J Bax
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-01
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2010-12-23     Revised Date:  2011-09-06    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  694-700     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity
Echocardiography, Doppler, Color / methods*
Echocardiography, Three-Dimensional / methods*
Feasibility Studies
Female
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Mitral Valve / pathology,  ultrasonography*
Mitral Valve Insufficiency / diagnosis*
Reproducibility of Results
Severity of Illness Index
Stroke Volume

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


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