scholarly journals The impact of different geometric assumption of mitral annulus on the assessment of mitral regurgitation volume by Doppler method 

2020 ◽  
Author(s):  
Wugang Wang ◽  
Zhibin Wang ◽  
Junfang Li ◽  
Kun Gong ◽  
Liang Zhao ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Three Dimensional ◽  
Reference Method ◽  
Mitral Annulus ◽  
Mean Difference ◽  
Significant Difference ◽  
Geometric Assumption ◽  
Three Dimensional Echocardiography ◽  
Regurgitant Orifice Area ◽  
The Impact

Abstract Background: Mitral regurgitation volume (MRvol) by quantitative pulsed Doppler (QPD) method previously recommended suffers from geometric assumption error because of circular geometric assumption of mitral annulus (MA). Therefore, the aim of this study was to evaluate the impact of different geometric assumption of MA on the assessment of MRvol by two-dimensional transthoracic echocardiographic QPD method. Methods: This study included 88 patients with varying degrees of mitral regurgitation (MR). The MRvol was evaluated by QPD method using circular or ellipse geometric assumption of MA. MRvol derived from effective regurgitant orifice area by real time three-dimensional echocardiography (RT3DE) multiplied by MR velocity-time integral was used as reference method. Results: Assumption of a circular geometry of MA, QPD-MAA4C and QPD-MAPLAX overestimated the MRvol by a mean difference of 10.4 ml (P ＜ 0.0001) and 22.5 ml (P ＜ 0.0001) compared with RT3DE. Assumption of a ellipse geometry of MA, there was no significant difference of MRvol (mean difference = 1.7 ml, P = 0.0844) between the QPD-MAA4C+A2C and the RT3DE. Conclusions: Assuming that the MA was circular geometry previously recommended, the MRvol by QPD-MAA4C was overestimated compared with the reference method. However, assuming that the MA was ellipse geometry, the MRvol by the QPD-MAA4C+A2C has no significant difference with the reference method.

scholarly journals The impact of different geometric assumption of mitral annular on the assessment of mitral regurgitation volume by Doppler method

2019 ◽  
Author(s):  
Wugang Wang ◽  
Zhibin Wang ◽  
Junfang Li ◽  
Kun Gong ◽  
Liang Zhao ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Three Dimensional ◽  
Reference Method ◽  
Mitral Annulus ◽  
Mean Difference ◽  
Significant Difference ◽  
Geometric Assumption ◽  
Three Dimensional Echocardiography ◽  
Regurgitant Orifice Area ◽  
The Impact

Abstract Background Mitral regurgitation volume (MRvol) by quantitative pulsed Doppler (QPD) method previously recommended suffers from geometric assumption error because of circular geometric assumption of mitral annulus (MA). Therefore, the aim of this study was to evaluate the impact of different geometric assumption of MA on the assessment of MRvol by two-dimensional transthoracic echocardiographic QPD method.Methods This study included 88 patients with varying degrees of mitral regurgitation (MR). The MRvol was evaluated by QPD method using circular or ellipse geometric assumption of MA. MRvol derived from effective regurgitant orifice area by real time three-dimensional echocardiography (RT3DE) multiplied by MR velocity-time integral was used as reference method.Results Assumption of a circular geometry of MA, QPD-MAA4C and QPD-MAPLAX overestimated the MRvol by a mean difference of 10.4 ml ( P < 0.0001) and 22.5 ml ( P < 0.0001) compared with RT3DE. Assumption of a ellipse geometry of MA, there was no significant difference of MRvol (mean difference = 1.7 ml, P = 0.0844) between the QPD-MAA4C+A2C and the RT3DE.Conclusions Assuming that the MA was circular geometry previously recommended, the MRvol by QPD-MAA4C was overestimated compared with the reference method. However, assuming that the MA was ellipse geometry, the MRvol by the QPD-MAA4C+A2C has no significant difference with the reference method.

The Role and Potential of 3D Echocardiography in the Assessment of Mitral Regurgitation

2012 ◽  
Vol 8 (3) ◽  
pp. 165 ◽  
Author(s):  
Astrid Apor ◽  
Anikó Nagy ◽  
Andrea Nagy ◽  
Béla Merkely ◽  
◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Three Dimensional ◽  
Mitral Annulus ◽  
Geometric Distortion ◽  
Surgical Reconstruction ◽  
Segmental Analysis ◽  
Valvular Lesion ◽  
Three Dimensional Echocardiography ◽  
Regurgitant Orifice Area ◽  
Conventional Echocardiography

Mitral regurgitation (MR) is the most commonly found valvular lesion in echocardiography laboratories. Moderate and severe mitral regurgitation have proven to be associated with increased morbidity and mortality, and surgical reconstruction is recommended in severe cases whenever feasible. Three-dimensional echocardiography (3DE) is superior to conventional echocardiography in the detailed assessment of the specific anatomical features and the pathomechanism of MR, and in the accurate grading of its severity. 3DE is adept in detecting and quantifying geometric distortion of the mitral annulus and analysing valve mechanics. Segmental analysis of leaflet pathology is considerably facilitated and quantification software packages offer new parameters for tailored surgical repair techniques. Direct visualisation of the anatomic regurgitant orifice and calculations of the effective regurgitant orifice area by 3D colour Doppler techniques promise to circumvent the limitations of conventional echocardiography in the quantification of mitral regurgitation.

A multiplanar three dimensional echocardiographic study of mitral valvar annular function in children with normal and regurgitant valves

2008 ◽  
Vol 18 (4) ◽  
pp. 379-385 ◽  
Author(s):  
Tara Bharucha ◽  
Muthukumaran C. Sivaprakasam ◽  
Kevin S. Roman ◽  
Joseph J. Vettukattil
Keyword(s):  
Mitral Regurgitation ◽  
Three Dimensional ◽  
Normal Subjects ◽  
Mitral Annulus ◽  
Mean Value ◽  
Left Ventricular ◽  
Two Dimensions ◽  
Normal Children ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

AbstractIntroductionThe mitral valvar complex is difficult to visualise accurately in only two dimensions. Three-dimensional echocardiography gives new insight into the dynamic changes of intra-cardiac structures during the cardiac cycle. The aim of this study was to study the mitral annulus in systole and diastole in normal children using three-dimensional echocardiography, and to analyse the effect of regurgitation on annular function.Materials and methodsThree-dimensional echocardiographic datasets, acquired in 11 consecutive subjects with mitral regurgitation, and 20 normal subjects, were analysed offline using simultaneous multiplanar review.ResultsThe mitral valvar annular area decreased in diastole, and increased in systole, in both groups. The annulus in patients with mitral regurgitation is dilated compared to normal subjects, the systolic value for those with regurgitation having a mean of 6.79 plus or minus 2.55 centimetres2/metres2, and the diastolic value a mean of 5.01 plus or minus 1.78 centimetres2/metres2, as opposed to a systolic mean value of 5.28 centimetres2/metres2 plus or minus 1.68, p = 0.091, and diastolic mean value of 3.05 centimetres2/metres2 plus or minus 0.90, in normal subjects (p less than 0.0001). The proportional change in mitral valvar annular area from systole to diastole showed a trend towards being smaller in those with mitral regurgitation, although this did not reach significance (24.8% versus 41.13%, p equal to 0.249). Analysis of subgroups of patients with moderate or severe mitral regurgitation showed mitral excursion, expressed as percentage of left ventricular length, to be significantly less than in normal subjects, at 12.78 plus or minus 5.10% versus 15.84 plus or minus 4.23% (p equal to 0.012).ConclusionsMitral valvar annular area in children decreases in diastole, and increases in systole. In those with mitral regurgitation, the annulus is dilated and the dynamic annular function is depressed.

The Role and Potential of 3D Echocardiography in the Assessment of Mitral Regurgitation

2012 ◽  
Vol 9 (2) ◽  
pp. 115-120
Author(s):  
Astrid Apor ◽  
Anikó Nagy ◽  
Andrea Nagy ◽  
Béla Merkely
Keyword(s):  
Mitral Regurgitation ◽  
Color Doppler ◽  
Three Dimensional ◽  
Mitral Annulus ◽  
Geometric Distortion ◽  
Surgical Reconstruction ◽  
Segmental Analysis ◽  
Valvular Lesion ◽  
Three Dimensional Echocardiography ◽  
Conventional Echocardiography

Mitral regurgitation (MR) is the most commonly found valvular lesion in echocardiography laboratories. Moderate and severe mitral regurgitation have proven to be associated with increased morbidity and mortality, and surgical reconstruction is recommended in severe cases whenever feasible. Three-dimensional echocardiography (3DE) is superior to conventional echocardiography in the detailed assessment of the specific anatomical features and the pathomechanism of MR, and in the accurate grading of its severity. 3DE is adept in detecting and quantifying geometric distortion of the mitral annulus and analysing valve mechanics. Segmental analysis of leaflet pathology is considerably facilitated and quantification software packages offer new parameters for tailored surgical repair techniques. Direct visualization of the anatomic regurgitant orifice and calculations of the effective regurgitant orifice area by 3D color Doppler techniques promise to circumvent the limitations of conventional echocardiography in the quantification of mitral regurgitation.

scholarly journals Severe mitral regurgitation recurrence after successful percutaneous mitral edge-to-edge repair by Mitraclip: Insights from a three-dimensional echocardiography study

2021 ◽  
Author(s):  
Yoan Lavie Badie ◽  
Fabien Vannier ◽  
Eve Cariou ◽  
Pauline Fournier ◽  
Romain Itier ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Primary Endpoint ◽  
Three Dimensional ◽  
Composite Endpoint ◽  
Line Length ◽  
Severe Mitral Regurgitation ◽  
Coaptation Line ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Background: The sustainability of the results of mitraclip procedures is a source of concern. Aims: To investigate risk factors of severe mitral regurgitation (MR) recurrence after Mitraclip in primary MR. Methods and results: Eighty-three patients undergoing successful Mitraclip procedures were retrospectively included. Valve anatomy and Mitraclips placement were comprehensively analyzed by post-processing 3D echocardiographic acquisition. The primary composite endpoint was the recurrence of severe MR. Mean age was 83±7 years-old, 37 (44%) were female. Median follow-up was 381 days (IQR 195-717) and 17 (20%) patients reached the primary endpoint. Main causes of recurrence of severe MR were relapse of a prolapse (64%) and single leaflet detachment (23%). Posterior coaptation line length (HR 1.06 95%CI 1.01-1.12 p=0.02), poor imaging quality (HR 3.84, 95%CI1.12-13.19; p=0.03), and inter-clip distance (HR 1.60, 95%CI 1.27-2.02; p<0.01) were associated with the occurrence of the primary endpoint. Conclusions: Recurrence of severe MR after a MitraClip procedure for primary MR is common and results from a complex interplay between anatomical (tissue excess) and procedural criteria (quality of ultrasound guidance and MitraClips spacing).

Sign in / Sign up

Export Citation Format

Share Document