TY - JOUR
T1 - Real-time three-dimensional color Doppler evaluation of the flow convergence zone for quantification of mitral regurgitation
T2 - Validation experimental animal study and initial clinical experience
AU - Sitges, Marta
AU - Jones, Michael
AU - Shiota, Takahiro
AU - Qin, Jian Xin
AU - Tsujino, Hiroyuki
AU - Bauer, Fabrice
AU - Kim, Yong Jin
AU - Agler, Deborah A.
AU - Cardon, Lisa A.
AU - Zetts, Arthur D.
AU - Panza, Julio A.
AU - Thomas, James D.
N1 - Funding Information:
Supported in part by grants NCC9-58 and NCC9-60, National Aeronautics and Space Administration, Houston, Tex, and grant 9951522V from the American Heart Association, Ohio Affiliate (Columbus, Ohio). M.S. was supported by a grant from the Spanish Ministry of Health (BEFI-00/9279).
PY - 2003/1/1
Y1 - 2003/1/1
N2 - Background: Pitfalls of the flow convergence (FC) method, including 2-dimensional imaging of the 3-dimensional (3D) geometry of the FC surface, can lead to erroneous quantification of mitral regurgitation (MR). This limitation may be mitigated by the use of real-time 3D color Doppler echocardiography (CE). Our objective was to validate a real-time 3D navigation method for MR quantification. Methods: In 12 sheep with surgically induced chronic MR, 37 different hemodynamic conditions were studied with real-time 3DCE. Using real-time 3D navigation, the radius of the largest hemispherical FC zone was located and measured. MR volume was quantified according to the FC method after observing the shape of FC in 3D space. Aortic and mitral electromagnetic flow probes and meters were balanced against each other to determine reference MR volume. As an initial clinical application study, 22 patients with chronic MR were also studied with this real-time 3DCE-FC method. Left ventricular (LV) outflow tract automated cardiac flow measurement (Toshiba Corp, Tokyo, Japan) and real-time 3D LV stroke volume were used to quantify the reference MR volume (MR volume = 3DLV stroke volume automated cardiac flow measurement). Results: In the sheep model, a good correlation and agreement was seen between MR volume by realtime 3DCE and electromagnetic (y = 0.77x + 1.48, r = 0.87, P < .001, Δ = -0.91 ± 2.65 mL). In patients, real-time 3DCE-derived MR volume also showed a good correlation and agreement with the reference method (y = 0.89x - 0.38, r = 0.93, P < .001, Δ = -4.8 ± 7.6 mL). Conclusions: real-time 3DCE can capture the entire FC image, permitting geometrical recognition of the FC zone geometry and reliable MR quantification.
AB - Background: Pitfalls of the flow convergence (FC) method, including 2-dimensional imaging of the 3-dimensional (3D) geometry of the FC surface, can lead to erroneous quantification of mitral regurgitation (MR). This limitation may be mitigated by the use of real-time 3D color Doppler echocardiography (CE). Our objective was to validate a real-time 3D navigation method for MR quantification. Methods: In 12 sheep with surgically induced chronic MR, 37 different hemodynamic conditions were studied with real-time 3DCE. Using real-time 3D navigation, the radius of the largest hemispherical FC zone was located and measured. MR volume was quantified according to the FC method after observing the shape of FC in 3D space. Aortic and mitral electromagnetic flow probes and meters were balanced against each other to determine reference MR volume. As an initial clinical application study, 22 patients with chronic MR were also studied with this real-time 3DCE-FC method. Left ventricular (LV) outflow tract automated cardiac flow measurement (Toshiba Corp, Tokyo, Japan) and real-time 3D LV stroke volume were used to quantify the reference MR volume (MR volume = 3DLV stroke volume automated cardiac flow measurement). Results: In the sheep model, a good correlation and agreement was seen between MR volume by realtime 3DCE and electromagnetic (y = 0.77x + 1.48, r = 0.87, P < .001, Δ = -0.91 ± 2.65 mL). In patients, real-time 3DCE-derived MR volume also showed a good correlation and agreement with the reference method (y = 0.89x - 0.38, r = 0.93, P < .001, Δ = -4.8 ± 7.6 mL). Conclusions: real-time 3DCE can capture the entire FC image, permitting geometrical recognition of the FC zone geometry and reliable MR quantification.
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U2 - 10.1067/mje.2003.37
DO - 10.1067/mje.2003.37
M3 - Article
C2 - 12514633
AN - SCOPUS:0037268522
SN - 0894-7317
VL - 16
SP - 38
EP - 45
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 1
ER -