Quantification of Functional Mitral Regurgitation by Real-Time 3D Echocardiography

Marsan, Nina Ajmone; Westenberg, Jos J.M.; Ypenburg, Claudia; Delgado, Victoria; Bommel, Rutger J. van; Roes, Stijntje D.; Nucifora, Gaetano; Geest, Rob J. van der; Roos, Albert de; Reiber, Johan; Schalij, Martin J.; Bax, Jeroen J.

doi:10.1016/j.jcmg.2009.07.006

Cited by 168 publications

(116 citation statements)

References 32 publications

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“…The correlation between VCW and EROA, both indexed or not, was significant in our study (ρ s = 0.825 and ρ s = 0.857). Others, however, have suggested that VCW may be overestimated in the case of eccentric jets, and in cases with a nonconcentric regurgitant area, the VC diameter obtained in M‐mode and 2‐D echocardiographic views may over‐ or underestimate the regurgitant area 40, 41…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Mitral Regurgitation Severity by Doppler Color Flow Mapping of the Vena Contracta in Dogs

Marcello¹,

Terzo

Locatelli

et al. 2014

Veterinary Internal Medicne

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BackgroundQuantitative and semiquantitative methods have been proposed for the assessment of MR severity, and though all are associated with limitations. Measurement of vena contracta width (VCW) has been used in clinical practice.ObjectiveTo measure the VCW in dogs with different levels of MR severity.AnimalsTwo hundred and seventy‐nine dogs were classified according to 5 levels of MR severity.MethodsThis was a retrospective study. EROA and regurgitant volume calculated by the PISA method, were measured and indexed to BSA. Descriptive statistics were calculated for VCW and VCW index for all categories of MR severity. Spearman's rank correlation coefficients (ρs) were calculated to compare the results of the different methods (VCW and VCW index vs RV PISA, RV PISA index, EROA, EROA index), and between VCW and VCW index versus MR severity.ResultsAll Spearman's rank correlation coefficients were significant (P < .001). The median values of VCW resulted of 2.9 mm (IQR 3.4–2.5) and of 4.6 mm (IQR 5.4–4.1) in the groups previously classified as mild‐to‐moderate and moderate‐to‐severe, respectively. The median values of VCW index resulted of 4.4 mm/m2 (IQR = 5.5–4.2) in mild‐to‐moderate MR and of 10.8 mm/m2 (IQR = 12.8–9.4) in moderate‐to‐severe MR.Conclusion and Clinical ImportanceThis is not a validation study against any previously validated invasive gold standard, the VCW method has proved easy to employ and it might be an additional tool in quantifying disease severity that supports, rather than replace, data coming from other techniques in daily clinical practice and research.

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Section: Discussionmentioning

confidence: 99%

“…Three‐dimensional color Doppler echocardiography has recently been suggested for the direct measurement of VCW and may overcome some of the limitations of the 2‐D echocardiographic techniques 21, 40, 41…”

Section: Discussionmentioning

confidence: 99%

Assessment of Mitral Regurgitation Severity by Doppler Color Flow Mapping of the Vena Contracta in Dogs

Marcello¹,

Terzo

Locatelli

et al. 2014

Veterinary Internal Medicne

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“…Passive LAA emptying is primarily related to a suction effect of passive LA emptying in early diastole in SR as well as in AF [13,14]. In SR, the e-wave velocity is a surrogate parameter for passive LAA emptying and is typically lower than active emptying velocities (Figure 3A) [14].…”

Section: Discussionmentioning

confidence: 99%

“…In SR, the e-wave velocity is a surrogate parameter for passive LAA emptying and is typically lower than active emptying velocities (Figure 3A) [14]. Being of little relevance in SR under physiological conditions, passive LAA emptying gains importance in situations with impaired active LAA emptying such as atrial stunning [3,4,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, plaques with retrograde flow in the descending aorta can be assessed by CMR as a potential non-cardiac source for cerebral embolism [12,13]. Velocity-encoded (VENC) CMR serves as the reference method for the quantification of intracardiac flow, indicating a potential use for measurements of LAA flow as a component of a comprehensive CMR protocol in patients at risk for stroke [14]. However, the assessment of LAA function by CMR has not been studied yet.…”

Section: Introductionmentioning

confidence: 99%

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Velocity encoded cardiovascular magnetic resonance to assess left atrial appendage emptying

Muellerleile

Sultan

Groth

et al. 2012

Journal of Cardiovascular Magnetic Resonance

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BackgroundThe presence of impaired left atrial appendage (LAA) function identifies patients who are prone to thrombus formation in the LAA and therefore being at high risk for subsequent cardioembolic stroke. LAA function is typically assessed by measurements of LAA emptying velocities using transesophageal echocardiography (TEE) in clinical routine. This study aimed at evaluating the feasibility of assessing LAA emptying by velocity encoded (VENC) cardiovascular magnetic resonance (CMR).MethodsThis study included 30 patients with sinus rhythm (n = 18) or atrial fibrillation (n = 12). VENC-CMR velocity measurements were performed perpendicular to the orifice of the LAA. Peak velocities were measured of passive diastolic LAA emptying (e-wave) in all patients. Peak velocities of active, late-diastolic LAA emptying (a-wave) were assessed in patients with sinus rhythm. Correlation and agreement was analyzed between VENC-CMR and TEE measurements of e- and a-wave peak velocities.ResultsA significant correlation and good agreement was found between VENC-CMR and TEE measurements of maximal e-wave velocities (r = 0.61, P < 0.001; mean difference 0 ± 10 cm/s). The a-wave was detectable by VENC-CMR in all patients with sinus rhythm. Correlation was also significant for measurements of peak a-wave velocities between VENC-CMR and TEE (r = 0.71, P < 0.001). There was no significant correlation of LAA emptying velocities with clinical characteristics and only a modest negative correlation of passive LAA emptying with LA function.ConclusionsThe assessment of active and passive LAA emptying by VENC-CMR is feasible. Further evaluation is required of potential future clinical applications such as risk stratification for cardioembolic stroke.

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Hemodynamic Measurements

Friedberg

2016

Echocardiography in Pediatric and Congenital Heart Disease

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Quantification of Functional Mitral Regurgitation by Real-Time 3D Echocardiography

Abstract: Quantification of EROA and Rvol of functional MR with 3D echocardiography is feasible and accurate as compared with VE-CMR; the currently recommended 2D echocardiographic approach significantly underestimates both EROA and Rvol.

Cited by 168 publications

References 32 publications

Assessment of Mitral Regurgitation Severity by Doppler Color Flow Mapping of the Vena Contracta in Dogs

Assessment of Mitral Regurgitation Severity by Doppler Color Flow Mapping of the Vena Contracta in Dogs

Velocity encoded cardiovascular magnetic resonance to assess left atrial appendage emptying

Hemodynamic Measurements

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