A Simple Different Method to Use Proximal Isovelocity Surface Area (PISA) for Measuring Mitral Valve Area

Uzun, Mehmet; Baysan, Oben; Erınç, Kürşad; Özkan, Mustafa; Sağ, Cemal; Genç, Celal; Karaeren, Hayrettin; Yokuşoğlu, Mehmet; Işık, Ersoy

doi:10.1007/s10554-005-4709-y

Cited by 11 publications

(5 citation statements)

References 21 publications

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“…It is known that invasive and echocardiographic methods have certain limitations in assessment of MS, and there might be discrepancies between methods in some circumstances [12][13][14][15][16][17]. In addition, the results obtained through these methods may be affected by the person who performs the action.…”

Section: Introductionmentioning

confidence: 99%

The relationship between the level of plasma B-type natriuretic peptide and mitral stenosis

Eryol

Doğan

Özdoğru

et al. 2006

Int J Cardiovasc Imaging

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B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are both secreted primarily from the ventricle myocardium in response to the increase in volume and pressure. We aimed to investigate the relationship between the severity of mitral stenosis (MS) and the level of plasma BNP. A total of 56 patients (50 female, 6 male) were included in the study. Mitral stenosis and its related parameters were evaluated by echocardiographic methods. Patients were divided into three groups as with mild, moderate and severe MS according to their planimetric valvular area. Plasma BNP levels were measured using "Triage-B-type natriuretic peptide test" method (Biosite Diagnostics, San Diego). The relationship of BNP with mitral stenosis and other echocardiographic parameters were studied. The comparison of the 3 groups with one another revealed that the BNP level in the group with moderate MS was higher than that in the group with mild MS, however it was statistically insignificant (74.9 +/- 49.7 versus 49.9 +/- 40.5 pg/ml, p > 0.05). BNP level in the group with severe MS was significantly higher than that in the mild MS (144.3 +/- 83.9 versus 49.9 +/- 40.5 pg/ml, p < 0.001) and that in the moderate MS group (144.3 +/- 83.9 versus. 74.9 +/- 49.7 pg/ml, p < 0.05). When patients were taken together, as the area of the mitral valve decreased, the level of BNP underwent a corresponding increase (r:-0.48, p < 0.001). We have ascertained that the level of plasma BNP and the degree of MS are significantly correlated, and as MS becomes more serious, the plasma BNP level rises.

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Section: Introductionmentioning

confidence: 99%

The relationship between the level of plasma B-type natriuretic peptide and mitral stenosis

Eryol

Doğan

Özdoğru

et al. 2006

Int J Cardiovasc Imaging

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“…In the spherical cap model, there is no need to measure the radius and the angle. Although, this model has been shown to be accurate in study settings, 8 routine use resulted in erroneous measurements. A possible reason might be that even the minimal errors in measuring the height of the cap caused major errors in MVA measurement.…”

Section: Discussionmentioning

confidence: 99%

“…Besides some concerns about the measurement of radius, the need for angle correction makes it too complex to use routinely. Although some efforts to eliminate need for angle correction have been made, 2,8,9 these methods have not been popular enough. A new method, which would simplify the PISA method, would be helpful for those who want to use it routinely.…”

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confidence: 99%

A Nomogram for Measurement of Mitral Valve Area by Proximal Isovelocity Surface Area Method

et al. 2007

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“…That is, PISA-flow = 2π × PISA-r 2 × Val × α/180, where PISA-r is the radius of the PISA cap in centimeters, Val is the aliasing velocity in cm/s, and α is the angle between mitral valve leaflets in degrees [7–12]. Several simplifications of the PISA equation have been suggested [13–16]. We have recently suggested that fixing α to 100 degrees and Val to 33 cm/s would not affect the accuracy of PISA and would leave only one parameter, PISA-r, apparently the most important in the PISA flow equation [17], allowing for a chance to study the effects of MS on the size of the PISA cap, determined by the PISA-r.…”

Section: Introductionmentioning

confidence: 99%

Radius of proximal isovelocity surface area in the assessment of rheumatic mitral stenosis: Connecting flow to anatomy and hemodynamics

Omar

Abdel-Rahman

Raslan

et al. 2015

Journal of the Saudi Heart Association

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a,b EgyptBackground: Echocardiographic assessment of left atrial pressure (LAP) in mitral stenosis (MS) is controversial. We sought to examine the role of the radius of the proximal isovelocity surface area (PISA-r) in the assessment of the hemodynamic status of MS after fixing the aliasing velocity (Val).Methods and results: We studied 42 candidates of balloon mitral valvuloplasty (BMV), for whom pre-BMV echocardiography was done and LAP invasively measured before dilatation. PISA-r was calculated after fixing aliasing velocity to 33 cm/s. In addition, the ratio IVRT/Te'-E was also measured, where IVRT was isovolumic relaxation time, and Te'-E was the time difference between the onset of mitral flow E-wave and mitral annular early diastolic velocity. IVRT/Te'-E and PISA-r showed a strong correlation with LAP (r = À0.715 and À0.637, all p < 0.001) and with right-sided pressures. In addition, PISA-r correlated with mitral valve area by planimetry method (MVA) and with left ventricular outflow tract stroke volume (r = 0.66 and 0.71, all p < 0.001). Receiver operator characteristic curve (ROC-curve) showed that PISA-r was not inferior to IVRT/Te'-E in differentiating LAP P25 from <25 mmHg.Conclusion: Provided that Val is set to a constant of 33 cm/s, PISA-r can assess the hemodynamic status of MS, and seems a simple alternative to the tedious IVRT/Te'-E for estimation of LAP.

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A Simple Different Method to Use Proximal Isovelocity Surface Area (PISA) for Measuring Mitral Valve Area

Abstract: Our method is an easy way for applying angle-corrected PISA method to mitral valve area measurement in patients with mitral stenosis. Absence of the need for estimating the angle is the major advantage.

Cited by 11 publications

References 21 publications

The relationship between the level of plasma B-type natriuretic peptide and mitral stenosis

The relationship between the level of plasma B-type natriuretic peptide and mitral stenosis

A Nomogram for Measurement of Mitral Valve Area by Proximal Isovelocity Surface Area Method

Radius of proximal isovelocity surface area in the assessment of rheumatic mitral stenosis: Connecting flow to anatomy and hemodynamics

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