Differential effect of 3-dimensional color doppler echocardiography for the quantifcation of mitral regurgitation according to the severity and characteristics

Jaehuk Choi, Ran Heo, Geu Ru Hong, Hyuk Jae Chang, Ji Min Sung, Sang Hoon Shin, In Jeong Cho, Chi Young Shim, Namsik Chung

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background-The aim of this study is to explore the differential effect of 3-dimensional color Doppler echocardiography for the quantifcation of mitral regurgitation (MR). Two-dimensional color Doppler echocardiography-based MR quantifcation has well-documented limitations. Methods and Results-We consecutively enrolled 221 patients with MR. Adequate image quality was obtained by 2D- and 3D-color Doppler echocardiography in 211 (95.5%) patients. The quantitative differences between the MR volumes obtained by 2D- and 3D-proximal isovelocity surface area (PISA) were analyzed in various MR subgroups. In the validation cohort (n=52), MR volume obtained by 3D-PISA showed a better agreement with phase-contrast cardiac MRI than 2D-PISA (r=0.97 versus 0.84). In all 211 patients, 2D-PISA underestimated the MR volume when compared with 3D-PISA (52.4±19.6 versus 59.5±25.6 mL; P=0.005). A total of 33.3% with severe MR based on 3D-PISA were incorrectly assessed by 2D-PISA as having nonsevere MR. In the subgroup analysis, the MR severity (odds ratio, 6.96; 95% confdence interval, 3.04-15.94; P<0.001) and having an asymmetrical orifce (odds ratio, 11.48; 95% confdence interval, 3.72-35.4; P<0.001), and an eccentric jet (odds ratio, 3.82; 95% confdence interval, 1.27-11.48; P=0.017) were predictors of signifcant difference in MR volume (>15 mL) between 2D- and 3D-PISA methods. Conclusions-Quantifcation of MR by 3D-PISA method is clinically feasible and more accurate than the current 2D-PISA method. MR quantifcation by 2D-PISA signifcantly underestimated MR volume with severe, eccentric MR with an asymmetrical orifce. This article demonstrates that 3D-color Doppler echocardiography could be used as a valuable tool to confrm treatment strategy in patients with signifcant MR.

Original languageEnglish
Pages (from-to)535-544
Number of pages10
JournalCirculation: Cardiovascular Imaging
Volume7
Issue number3
DOIs
Publication statusPublished - 2014 Jul

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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