| Three-dimensional color Doppler echocardiography for direct measurement of vena contracta area in mitral regurgitation: in vitro validation and clinical experience. | |
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MedLine Citation:
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PMID: 19356505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Our goal was to prospectively compare the accuracy of real-time three-dimensional (3D) color Doppler vena contracta (VC) area and two-dimensional (2D) VC diameter in an in vitro model and in the clinical assessment of mitral regurgitation (MR) severity. BACKGROUND: Real-time 3D color Doppler allows direct measurement of VC area and may be more accurate for assessment of MR than the conventional VC diameter measurement by 2D color Doppler. METHODS: Using a circulatory loop with an incorporated imaging chamber, various pulsatile flow rates of MR were driven through 4 differently sized orifices. In a clinical study of patients with at least mild MR, regurgitation severity was assessed quantitatively using Doppler-derived effective regurgitant orifice area (EROA), and semiquantitatively as recommended by the American Society of Echocardiography. We describe a step-by-step process to accurately identify the 3D-VC area and compare that measure against known orifice areas (in vitro study) and EROA (clinical study). RESULTS: In vitro, 3D-VC area demonstrated the strongest correlation with known orifice area (r = 0.92, p < 0.001), whereas 2D-VC diameter had a weak correlation with orifice area (r = 0.56, p = 0.01). In a clinical study of 61 patients, 3D-VC area correlated with Doppler-derived EROA (r = 0.85, p < 0.001); the relation was stronger than for 2D-VC diameter (r = 0.67, p < 0.001). The advantage of 3D-VC area over 2D-VC diameter was more pronounced in eccentric jets (r = 0.87, p < 0.001 vs. r = 0.6, p < 0.001, respectively) and in moderate-to-severe or severe MR (r = 0.80, p < 0.001 vs. r = 0.18, p = 0.4, respectively). CONCLUSIONS: Measurement of VC area is feasible with real-time 3D color Doppler and provides a simple parameter that accurately reflects MR severity, particularly in eccentric and clinically significant MR where geometric assumptions may be challenging. |
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Authors:
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Stephen H Little; Bahar Pirat; Rahul Kumar; Stephen R Igo; Marti McCulloch; Craig J Hartley; Jiaqiong Xu; William A Zoghbi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Validation Studies Date: 2008-11-18 |
Journal Detail:
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Title: JACC. Cardiovascular imaging Volume: 1 ISSN: 1876-7591 ISO Abbreviation: JACC Cardiovasc Imaging Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2009-04-09 Completed Date: 2009-04-23 Revised Date: 2009-05-21 |
Medline Journal Info:
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Nlm Unique ID: 101467978 Medline TA: JACC Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 695-704 Citation Subset: IM |
Affiliation:
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The Methodist DeBakey Heart and Vascular Center, Houston, Texas 77030, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Echocardiography, Doppler, Color* Echocardiography, Three-Dimensional* Feasibility Studies Female Hemorheology Humans Image Interpretation, Computer-Assisted Male Middle Aged Mitral Valve / physiopathology, ultrasonography* Mitral Valve Insufficiency / physiopathology, ultrasonography* Observer Variation Predictive Value of Tests Prospective Studies Pulsatile Flow Reproducibility of Results Severity of Illness Index Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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