Evaluation of mitral valve area by the proximal isovelocity surface area method in mitral stenosis: could it be simplified?

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
David Messika-ZeitounAlec Vahanian

Abstract

One limitation for a wider use of the proximal isovelocity surface area method (PISA) for the evaluation of the mitral valve area (MVA) in patients with mitral stenosis (MS) is the requirement of an angle correction factor (angle alpha between the mitral leaflets) which cannot be obtained using the machine's built-in software and requires a manual measurement. The aim of the present study was to evaluate if the use of a fixed angle could provide an acceptable MVA estimation. In 48 patients (53 +/- 14 years, 75% female and 32% atrial fibrillation), MVA was prospectively measured by planimetry (MVA(2D)) and PISA (PISA(mes)). The angle alpha was manually measured on paper prints using a protractor. MVA(2D) was 1.38 +/- 0.56 cm(2) [0.5-2.40]. PISA(mes) (alpha = 104 +/- 13 degrees inter-quartiles 90-115) was 1.34 +/- 0.64 cm(2) [0.31-2.95] and did not differ from and correlated well with MVA(2D) (P = 0.25; r = 0.93, P < 0.0001). MVA estimated using the PISA method and a fixed angle value from 90 to 110 (MVA(alpha)(=90) to MVA(alpha)(=110)) progressively increased from 1.20 +/- 0.66 to 1.48 +/- 0.81 cm(2). Only MVA(alpha)(=100) (1.34 +/- 0.74 cm(2)) did not differ from and correlated well with both MVA(2D) and PISA(mes) (both P > 0.3...Continue Reading

Citations

Aug 10, 2011·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Julien DreyfusDavid Messika-Zeitoun
Jan 27, 2011·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Alaa Mabrouk Salem OmarKen-ichi Hirata

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