Real-time three-dimensional color doppler evaluation of the flow convergence zone for quantification of mitral regurgitation: Validation experimental animal study and initial clinical experience

2003 ◽  
Vol 16 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Marta Sitges ◽  
Michael Jones ◽  
Takahiro Shiota ◽  
Jian Xin Qin ◽  
Hiroyuki Tsujino ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Real Time ◽  
Animal Study ◽  
Experimental Animal ◽  
Color Doppler ◽  
Three Dimensional ◽  
Convergence Zone ◽  
Flow Convergence ◽  
Experimental Animal Study ◽  
Doppler Evaluation

Abstract 3382: Three-Dimensional Color Doppler Echocardiography for Direct Measurement of Mitral Regurgitation Vena Contracta Area: A Clinical Experience

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Stephen H Little ◽  
Rahul Kumar ◽  
Bahar Pirat ◽  
Marti L McCulloch ◽  
William A Zoghbi
Keyword(s):  
Mitral Regurgitation ◽  
Stroke Volume ◽  
Real Time ◽  
Direct Measurement ◽  
Color Doppler ◽  
Three Dimensional ◽  
Vena Contracta ◽  
Doppler Study ◽  
3D Color Doppler ◽  
Valve Pathology

Introduction: 3D color Doppler allows a direct measurement of Vena Contracta (VC) area in patients with mitral regurgitation (MR), without the need for geometric assumptions. Hypothesis: 3D color Doppler VC area provides a more accurate assessment of MR severity than the conventional 2D color Doppler VC diameter. Methods: Patients with ≥ mild MR underwent 2D and 3D color Doppler and a quantitative echo-Doppler study. 2D VC diameter was measured from a zoomed parasternal long-axis view. 3D VC area was acquired using real-time 3D (Philips) and measured off-line (TomTec). MR severity was assessed both quantitatively, as effective regurgitant orifice area from pulsed Doppler [EROA = (mitral stroke volume - aortic stroke volume)/MR time velocity integral], and semi-quantitatively as recommended by the American Society of Echocardiography. Results: 61 patients (65 ± 15 years) were studied. MR severity was mild in 25%, moderate in 36%, and moderate to severe or severe in 39%. Mitral valve pathology was prolapse in 33%, restricted closure in 44% and annular calcification in 7%. Regurgitant MR jet was eccentric in 49% of patients. For all patients, 3D VC area correlated significantly with EROA, better than 2D VC diameter (figure ). The advantage of 3D VC area over 2D VC diameter was more pronounced in eccentric jets (r=0.76, p< 0.001 vs. r=0.5, p =0.006, respectively) and in moderate to severe or severe MR (r=0.65, p<0.001 vs. r =0.13, p=0.54, respectively). Conclusions : Measurement of VC area is feasible with real-time 3D 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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