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Automated Quantification of Mitral Regurgitation by Three Dimensional Real Time Full Volume Color Doppler Transthoracic Echocardiography: A Validation with Cardiac Magnetic Resonance Imaging and Comparison with Two Dimensional Quantitative Methods

Authors
 Jang-Won Son  ;  Hyuk-Jae Chang  ;  Jin-Kyung Lee  ;  Hee-Jung Chung  ;  Ran-Young Song  ;  Young-Jin Kim  ;  Saurabh Datta  ;  Ran Heo  ;  Sang-Hoon Shin  ;  In-Jeong Cho  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Namsik Chung 
Citation
 Journal of Cardiovascular Ultrasound, Vol.21(2) : 81-89, 2013 
Journal Title
 Journal of Cardiovascular Ultrasound 
ISSN
 1975-4612 
Issue Date
2013
Keywords
3D echocardiography ; Mitral regurgitation ; Quantitative evaluation
Abstract
BACKGROUND: Accurate assessment of mitral regurgitation (MR) severity is crucial for clinical decision-making and optimizing patient outcomes. Recent advances in real-time three dimensional (3D) echocardiography provide the option of real-time full volume color Doppler echocardiography (FVCD) measurements. This makes it practical to quantify MR by subtracting aortic stroke volume from the volume of mitral inflow in an automated manner. METHODS: Thirty-two patients with more than a moderate degree of MR assessed by transthoracic echocardiography (TTE) were consecutively enrolled during this study. MR volume was measured by 1) two dimensional (2D) Doppler TTE, using the proximal isovelocity surface area (PISA) and the volumetric quantification methods (VM). Then, 2) real time 3D-FVCD was subsequently obtained, and dedicated software was used to quantify the MR volume. MR volume was also measured using 3) phase contrast cardiac magnetic resonance imaging (PC-CMR). In each patient, all these measurements were obtained within the same day. Automated MR quantification was feasible in 30 of 32 patients. RESULTS: The mean regurgitant volume quantified by 2D-PISA, 2D-VM, 3D-FVCD, and PC-CMR was 72.1 ± 27.7, 79.9 ± 36.9, 69.9 ± 31.5, and 64.2 ± 30.7 mL, respectively (p = 0.304). There was an excellent correlation between the MR volume measured by PC-CMR and 3D-FVCD (r = 0.85, 95% CI 0.70-0.93, p < 0.001). Compared with PC-CMR, Bland-Altman analysis for 3D-FVCD showed a good agreement (2 standard deviations: 34.3 mL) than did 2D-PISA or 2D-VM (60.0 and 62.8 mL, respectively). CONCLUSION: Automated quantification of MR with 3D-FVCD is feasible and accurate. It is a promising tool for the real-time 3D echocardiographic assessment of patients with MR.
Files in This Item:
T201303320.pdf Download
DOI
10.4250/jcu.2013.21.2.81
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Son, Jang Won(손장원)
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Heo, Ran(허란)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87985
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