AI Article Synopsis
- The study aimed to compare the accuracy of real-time 3D color Doppler vena contracta (VC) area versus traditional 2D VC diameter in evaluating mitral regurgitation (MR) severity.
- In both an in vitro model and a clinical setting, real-time 3D VC area showed a stronger correlation with known orifice sizes and Doppler-derived effective regurgitant orifice area than 2D measurements, especially in cases of eccentric MR jets and more severe MR.
- The findings suggest that using 3D VC area measurements can provide a more reliable and straightforward method for assessing MR severity in patients.
Article Abstract
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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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357190 | PMC |
| http://dx.doi.org/10.1016/j.jcmg.2008.05.014 | DOI Listing |
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