Three‐dimensional proximal flow convergence automatic calculation for determining mitral valve area in rheumatic mitral stenosis

Sampaio, Francisco; Ladeiras-Lopes, Ricardo; Almeida, João; Fonseca, Paulo; Fontes‐Carvalho, Ricardo; Ribeiro, José; Gama, Vasco

doi:10.1111/echo.13558

Cited by 3 publications

(4 citation statements)

References 43 publications

(93 reference statements)

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“…Relying on traditional measures of valve disease severity is becoming increasingly difficult to defend with the development of technologies that offer clear advantages over 2D imaging. In relation to MS, there have been a number of recent advancements with respect to 3D technology including the introduction of modelling ( 7 ), semi-automated valve area tracing ( 8 ) and analysis of proximal flow convergence ( 9 , 10 ). These 3D methods offer potential gains over standard imaging as the irregularity of the mitral valve means that during diastole, its leaflet tips cut across single planes making it difficult to ensure correct alignment.…”

Section: Discussionmentioning

confidence: 99%

Impact of 3D echocardiography on grading of mitral stenosis and prediction of clinical events

et al. 2018

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BackgroundThe mitral valve orifice area (MVOA) is difficult to assess accurately by 2D echocardiography because of geometric assumptions; therefore, 3D planimetry may offer advantages. We studied the differences in MVOA measurements between the most frequently used methods, to determine if 3D planimetry would result in the re-grading of severity in any cases, and whether it was a more accurate predictor of clinical outcomes.MethodsThis was a head-to-head comparison of the three most commonly used techniques to grade mitral stenosis (MS) by orifice area and to assess their impact on clinical outcomes. 2D measurements (pressure half-time (PHT), planimetry) and 3D planimetry were performed retrospectively on patients with at least mild MS. The clinical primary endpoint was defined as a composite of MV balloon valvotomy, mitral valve repair or replacement (MVR) and/or acute heart failure (HF) admissions.ResultsForty-one consecutive patients were included; the majority were female (35; 85.4%), average age 55 (17) years. Mean and peak MV gradients were 9.4 (4) mmHg and 19 (6) mmHg, respectively. 2D and 3D measures of MVOA differed significantly; mean 2D planimetry MVOA was 1.28 (0.40) cm2, mean 3D planimetry MVOA 1.15 (0.29) cm2 (P = 0.003). Mean PHT MVOA was 1.43 (0.44) cm2 (P = 0.046 and P < 0.001 in comparison to 2D and 3D planimetry methods, respectively). 3D planimetry reclassified 7 (17%) patients from mild-to-moderate MS, and 1 (2.4%) from moderate to severe. Overall, differences between the two methods were significant (X2, P < 0.001). Only cases graded as severe by 3D predicted the primary outcome measure compared with mild or moderate cases (odds ratio 5.7).Conclusion3D planimetry in MS returns significantly smaller measurements, which in some cases results in the reclassification of severity. Routine use of 3D may significantly influence the management of MS, with a degree of prediction of clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Impact of 3D echocardiography on grading of mitral stenosis and prediction of clinical events

et al. 2018

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“…In addition, 3D imaging allows a more comprehensive assessment of the mitral valve and the subvalvular apparatus as was apparent from the very early studies utilizing 3D echocardiography . Studies are quite consistent in describing high feasibility (88%–100%) and reproducibility of this approach . Table presents data for comparative studies excluding the studies that used 3D‐guided 2D planimetry as the reference method .…”

Section: Mitral Stenosismentioning

confidence: 97%

“…30 Studies are quite consistent in describing high feasibility (88%-100%) and reproducibility of this approach. [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] Table 2 presents data for comparative studies excluding the studies that used 3D-guided 2D planimetry as the reference method. 45,47 Mean time needed for offline MVA measurements was 2 ± 1 minutes in one study.…”

Section: Mitral Stenosismentioning

confidence: 99%

Echocardiographic 3D‐guided 2D planimetry in quantifying left‐sided valvular heart disease

Argulian

Seetharam

2018

Echocardiography

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Echocardiographic 3D-guided 2D planimetry can improve the accuracy of valvular disease assessment. Acquisition of 3D pyramidal dataset allows subsequent multiplanar reconstruction with accurate orthogonal plane alignment to obtain the correct borders of an anatomic orifice or flow area. Studies examining the 3D-guided 2D planimetry approach in left-sided valvular heart disease were identified and reviewed. The strongest evidence exists for estimating mitral valve area in patients with rheumatic mitral valve stenosis and vena contracta area in patients with mitral regurgitation (both primary and secondary). 3D-guided approach showed excellent feasibility and reproducibility in most studies, as well as time efficiency and good correlation with reference and comparator methods. Therefore, 3D-guided 2D planimetry can be used as an important clinical tool in quantifying left-sided valvular heart disease, especially mitral valve disorders.

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“…The MV area obtained with RT3DE PISA has also been compared with RT3DE and 2DE planimetry. The semi-automated RT3DE quantification of the MV area might be more accurate than conventional 2D methods [ 61 , 62 ].…”

Section: Know Whenmentioning

confidence: 99%

Clinical Utility of Three-Dimensional Echocardiography in the Evaluation of Mitral Valve Disease: Tips and Tricks

Pino

Madeo

Lucà

et al. 2023

JCM

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Although real-time 3D echocardiography (RT3DE) has only been introduced in the last decades, its use still needs to be improved since it is a time-consuming and operator-dependent technique and acquiring a good quality data can be difficult. Moreover, the additive value of this important diagnostic tool still needs to be wholly appreciated in clinical practice. This review aims at explaining how, why, and when performing RT3DE is useful in clinical practice.

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Three‐dimensional proximal flow convergence automatic calculation for determining mitral valve area in rheumatic mitral stenosis

Abstract: MVA estimation using 3D PISA was feasible and more accurate than 2D methods. Its introduction in daily clinical practice seems possible and may overcome technical limitations of 2D methods.

Cited by 3 publications

References 43 publications

Impact of 3D echocardiography on grading of mitral stenosis and prediction of clinical events

Impact of 3D echocardiography on grading of mitral stenosis and prediction of clinical events

Echocardiographic 3D‐guided 2D planimetry in quantifying left‐sided valvular heart disease

Clinical Utility of Three-Dimensional Echocardiography in the Evaluation of Mitral Valve Disease: Tips and Tricks

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