Diagnostic Value of Color Flow Mapping and Doppler Echocardiography in the Quantification of Mitral Regurgitation in Patients with Mitral Valve Prolapse or Rheumatic Heart Disease

Pinheiro, Aurélio; Mancuso, Frederico José Neves; Hemerly, Daniela Fernanda Alli; Kiyose, Alberto Takeshi; Campos, Orlando; Andrade, José L.; Paola, Ângelo A. V. de; Carvalho, Antônio Carlos; Moisés, Valdir Ambrósio

doi:10.1016/j.echo.2007.02.029

Cited by 9 publications

(6 citation statements)

References 37 publications

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“…This is the first study to address the MR classification by different echocardiographic methods in patients with DCM. A previous study, which included patients with myxomatous or rheumatic etiology MR, unlike our study, showed a good agreement between the quantitative echocardiographic methods 15 .…”

Section: Discussionsupporting

confidence: 70%

“…The MR evaluation and classification remains a challenge, even in patients with primary valvular disease, which has been the reason for recent publications 15-18 . This is the first study to address the MR classification by different echocardiographic methods in patients with DCM.…”

Section: Discussionmentioning

confidence: 99%

“…It is unknown whether the recommendations of the American Society of Echocardiography (ASE), together with the European Society of Cardiology Working Group for evaluation and classification of primary valvular insufficiency by Doppler echocardiography 14 are suitable for patients with functional MR and DCM. Additionally, the different methods using Doppler echocardiography and color flow mapping were validated in clinical studies for patients showing different causes of primary MR 15 , but not specifically for patients with DCM.…”

Section: Introductionmentioning

confidence: 99%

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Criteria for Mitral Regurgitation Classification were inadequate for Dilated Cardiomyopathy

Mancuso¹,

Moisés²,

Almeida³

et al. 2013

Arquivos Brasileiros De Cardiologia

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BackgroundMitral regurgitation (MR) is common in patients with dilated cardiomyopathy (DCM). It is unknown whether the criteria for MR classification are inadequate for patients with DCM. ObjectiveWe aimed to evaluate the agreement among the four most common echocardiographic methods for MR classification. MethodsNinety patients with DCM were included. Functional MR was classified using four echocardiographic methods: color flow jet area (JA), vena contracta (VC), effective regurgitant orifice area (ERO) and regurgitant volume (RV). MR was classified as mild, moderate or important according to the American Society of Echocardiography criteria and by dividing the values into terciles. The Kappa test was used to evaluate whether the methods agreed, and the Pearson correlation coefficient was used to evaluate the correlation between the absolute values of each method. ResultsMR classification according to each method was as follows: JA: 26 mild, 44 moderate, 20 important; VC: 12 mild, 72 moderate, 6 important; ERO: 70 mild, 15 moderate, 5 important; RV: 70 mild, 16 moderate, 4 important. The agreement was poor among methods (kappa = 0.11; p < 0.001). It was observed a strong correlation between the absolute values of each method, ranging from 0.70 to 0.95 (p < 0.01) and the agreement was higher when values were divided into terciles (kappa = 0.44; p < 0.01) ConclusionThe use of conventional echocardiographic criteria for MR classification seems inadequate in patients with DCM. It is necessary to establish new cutoff values for MR classification in these patients.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Criteria for Mitral Regurgitation Classification were inadequate for Dilated Cardiomyopathy

Mancuso¹,

Moisés²,

Almeida³

et al. 2013

Arquivos Brasileiros De Cardiologia

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“…Several authors have demonstrated the limitations involved with two-dimensional VC measures (Fig. 6) [21,26,28]. As noted by Yosefy et al [26], the available imaging planes for the VC are often cut obliquely across the flow stream and may include portions of the expanding jet leading to overestimation of the VC diameter.…”

Section: Vena Contracta For Flow Quantificationmentioning

confidence: 97%

“…In one study of patients with organic MR (rheumatic heart disease and/or mitral valve prolapse) it was demonstrated that calculation of the EROA using the 2D PISA method had good accuracy to identify patients with clinically significant MR (accuracy 96%) and was superior to measures of color jet area or to the ratio of jet area to left atrial area [21]. In contrast, Matsumura and colleagues [22•] demonstrated that in patients with functional MR, the 2D PISA method underestimated EROA by as much as 24%.…”

Section: D Pisa Limitationsmentioning

confidence: 98%

Quantifying Mitral Regurgitation: Added Value of Three-Dimensional Echocardiography

Little

2011

Curr Cardiovasc Imaging Rep

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Current three-dimensional (3D) echocardiographic technology, including live 3D transesophageal echocardiography and single-beat 3D color Doppler imaging, are providing valuable new insight into the mechanism and quantification of mitral valve dysfunction. In this review we discuss important applications of 3D volumetric leaflet imaging with emphasis on the distinction between organic and functional mitral regurgitation. We also discuss the added benefit of current and emerging 3D color Doppler methods for the quantification of mitral regurgitation severity. The limitations of the 2D proximal isovelocity surface area method are discussed, along with potential solutions provided by 3D color Doppler imaging methods that do not require assumptions about the converging flow geometry. Methods to directly measure the vena contracta area of a regurgitant jet are presented along with recent validation studies comparing this method to a reference standard of cardiac MRI. In brief, we review the established and emerging applications of 3D color Doppler techniques for the quantification of mitral regurgitation severity.

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Diseases of the Mitral Valve

Yin

Hsiung

2016

Atlas of Perioperative 3D Transesophageal Echocardiography

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Diagnostic Value of Color Flow Mapping and Doppler Echocardiography in the Quantification of Mitral Regurgitation in Patients with Mitral Valve Prolapse or Rheumatic Heart Disease

Cited by 9 publications

References 37 publications

Criteria for Mitral Regurgitation Classification were inadequate for Dilated Cardiomyopathy

Criteria for Mitral Regurgitation Classification were inadequate for Dilated Cardiomyopathy

Quantifying Mitral Regurgitation: Added Value of Three-Dimensional Echocardiography

Diseases of the Mitral Valve

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