Measurement of mitral valve area in patients with mitral stenosis by 3D echocardiography: A comparison between direct planimetry on 3D zoom and 3D quantification

摘要

Abstract Background Measurement of the mitral valve area ( MVA ) in patients with mitral stenosis ( MS ) by 3D echocardiography (3 DE ) is usually done via 3D quantification (3 DQ ). The present study on patients with severe MS sought to evaluate the agreement regarding the MVA measurement between 3 DQ and direct planimetry on 3D zoom and also between 3 DE and 2 DE . Methods Twenty‐six patients (22 female, mean age:34.5?±?14.0?years) with severe MS diagnosed by 2D transthoracic echocardiography(2 DTTE ) underwent 3D transesophageal echocardiography (3 DTEE ). Direct planimetry, the pressure half‐time ( PTH ), and the continuity equation( CE ) constituted 3 conventional 2 DTTE methods, and 3 DQ and direct planimetry on 3D zoom comprised two 3 DTEE methods applied for the MVA measurement. Agreement between the 2D and 3D methods was assessed using the Bland–Altman plot and measuring the intra‐class correlation coefficient ( ICC ). Results The mean MVA measured by 3 DQ was significantly larger than that derived by direct planimetry on 3D zoom (0.935?±?0.23?cm 2 vs 0.846?±?0.22?cm 2 , respectively; P? = ? 0.026). The agreement between 3 DQ and 3D zoom for the MVA measurement was moderate to good by the Bland–Altman plot ( ICC ?=?0.67). The mean MVA measured by 2 DE (all 3 methods of direct planimetry, the PTH , and the CE ) was significantly larger than that derived by 3 DE (both methods of 3 DQ and direct planimetry on 3D zoom) (all Ps? ? 0.05). A moderate agreement between 3 DQ and 2D planimetry ( ICC ?=?0.43) was found by the Bland–Altman plot. Conclusions The MVA measurement by direct planimetry on 3D zoom showed a moderate‐to‐good agreement with 3 DQ ; it may, thus, be used in clinical practice as a simple method for the measurement of the MVA in patients with MS .