Comparison of three-dimensional proximal isovelocity surface area to cardiac magnetic resonance imaging for quantifying mitral regurgitation

The American Journal of Cardiology
Nicolas BruggerChristian Seiler

Abstract

The aim of our study was to evaluate 3-dimensional (3D) color Doppler proximal isovelocity surface area (PISA) as a tool for quantitative assessment of mitral regurgitation (MR) against in vitro and in vivo reference methods. A customized 3D PISA software was validated in vitro against a flowmeter MR phantom. Sixty consecutive patients, with ≥mild MR of any cause, were recruited and the regurgitant volume (RVol) was measured by 2D PISA, 3D peak PISA, and 3D integrated PISA, using transthoracic (TTE) and transesophageal echocardiography (TEE). Cardiac magnetic resonance imaging (CMR) was used as reference method. Flowmeter RVol was associated with 3D integrated PISA as follows: y = 0.64x + 4.7, r(2) = 0.97, p <0.0001 for TEE and y = 0.88x + 4.07, r(2) = 0.96, p <0.0001 for TTE. The bias and limit of agreement in the Bland-Altman analysis were 6.8 ml [-3.5 to 17.1] for TEE and -0.059 ml [-6.2 to 6.1] for TTE. In vivo, TEE-derived 3D integrated PISA was the most accurate method for MR quantification compared to CMR: r(2) = 0.76, y = 0.95x - 3.95, p <0.0001; 5.1 ml (-14.7 to 26.5). It was superior to TEE 3D peak PISA (r(2) = 0.67, y = 1.00x + 6.20, p <0.0001; -6.3 ml [-33.4 to 21.0]), TEE 2D PISA (r(2) = 0.54, y = 0.76x + 0.18, p <...Continue Reading

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Citations

Mar 10, 2017·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Fabian ZürcherChristian Seiler
Dec 11, 2019·Nature Reviews. Cardiology·Pankaj GargSaul G Myerson
May 21, 2020·Frontiers in Cardiovascular Medicine·Mirjam G WinkelFabien Praz
May 19, 2020·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Chloé PapollaRégis Rieu
Jun 19, 2021·European Heart Journal Cardiovascular Imaging·Ahmet DemirkiranMarco J W Götte

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