Determination of Regurgitant Orifice Area with the Use of a New Three-Dimensional Flow Convergence Geometric Assumption in Functional Mitral Regurgitation

Yoshiki Matsumura, Giuseppe Saracino, Kenichi Sugioka, Hung Tran, Neil L. Greenberg, Nozomi Wada, Manatomo Toyono, Shota Fukuda, Takeshi Hozumi, James D. Thomas, Junichi Yoshikawa, Minoru Yoshiyama, Takahiro Shiota*

*Corresponding author for this work

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

Geometry of the proximal isovelocity surface area (PISA) in functional mitral regurgitation (MR) is elongated, leading to underestimation of the effective regurgitant orifice (ERO) area. This underestimation could be corrected by a new hemiellipsoidal method. Thirty patients with functional MR were examined by real-time 3-dimensional (D) echocardiography. Two ERO areas were calculated from 3D measurements: ERO area by the hemispheric method and that by the new hemiellipsoidal method with our customized program. Each ERO area was compared with that by the 2D quantitative Doppler method. Color 3D images showed an elongated PISA geometry including 2 geometric types ("mountain" or "valley") in all patients with functional MR. Our hemiellipsoidal method could be adapted for all geometric types of PISA and underestimated ERO area by only 26%, whereas the underestimation by the hemispheric PISA method was 49%. The underestimation by the hemispheric PISA method can be significantly corrected by our hemiellipsoidal method.

Original languageEnglish (US)
Pages (from-to)1251-1256
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume21
Issue number11
DOIs
StatePublished - Nov 2008

Keywords

  • Cardiomyopathy
  • Echocardiography
  • Mitral valve
  • Regurgitation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Matsumura, Y., Saracino, G., Sugioka, K., Tran, H., Greenberg, N. L., Wada, N., Toyono, M., Fukuda, S., Hozumi, T., Thomas, J. D., Yoshikawa, J., Yoshiyama, M., & Shiota, T. (2008). Determination of Regurgitant Orifice Area with the Use of a New Three-Dimensional Flow Convergence Geometric Assumption in Functional Mitral Regurgitation. Journal of the American Society of Echocardiography, 21(11), 1251-1256. https://doi.org/10.1016/j.echo.2008.09.004