Two‑dimensional transthoracic measure of mitral annulus in mitral valve prolapse and moderate to severe regurgitation: a method comparison analysis with three‑dimensional transesophageal echocardiography
10.1186/s44348-024-00001-w
- Author:
Maxime BERTHELOT‑RICHER
1
;
Halyna Viktorivna VAKULENKO
;
Anna CALLEJA
;
Anna WOO
;
Paaladinesh THAVENDIRANATHAN
;
Frédéric POULIN
Author Information
1. Department of Cardiology, Hôpital du Sacré-Cœur de Montréal, University of Montreal, 5400 Gouin W Blvd, Montréal, QC H4J 1C5, Canada
- Publication Type:ORIGINAL ARTICLE
- From:
Journal of Cardiovascular Imaging
2024;32(1):2-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Mitral annulus (MA) area is derived during transthoracic echocardiography (TTE) assuming of a circu‑ lar shape using the MA diameter from the apical 4 chamber (A4c) view. Since the MA is not a circular structure, we hypothesized that an elliptical model using parasternal long-axis (PLAX) and apical 2 chamber (A2c) view measured MA diameters would have better agreement with 3-dimensional transesophageal echocardiography (3D TEE) meas‑ ured MA in degenerative mitral valve disease (DMVD).
Methods:Seventy-six patients with moderate-to-severe DMVD had 2D TTE and 3D TEE performed. MA area was measured retrospectively using semi-automatic modeling of 3D data (3D TEEsa ) and considered as the reference method. MA diameters were measured using different 2D TTE views. MA area was calculated using assumptions of a circular or an elliptical shape. 2D TTE derived and 3D TEEsa . MA areas were compared using linear regression and Bland-Altman analysis.
Results:The median MA area measured at 3D TEEsa was 1,386 (1,293–1,673) mm2 . With 2D TTE, the circular model using A4c view diameter resulted in a small systematic underestimation of MA area (6%), while the elliptical model using PLAX and A2c diameters resulted in 25% systematic underestimation. The standard deviations of the distribu‑tions of inter-method differences were wide for all 2D TTE methods (265–289 mm2 ) when compared to 3D TEEsa , indicating imprecision.
Conclusions:When compared with 3D TEEsa modeling of the MA as the reference, the assumption of a circular shapeusing A4c TTE view diameter was the method with the least systematic error to assess MA area in DMVD and moder‑ ate to severe regurgitation.
