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Background: Mitral valve area (MVA) measurement by three-dimensional transesophageal echocardiography (3D-TEE) has a crucial role in the evaluation of mitral stenosis (MS) severity. Threedimensional direct (3D-direct) planimetry has been proposed as a new technique to measure mitral valve area. This study aimed to compare the 3D-direct mitral valve planimetry to conventional threedimensional multiplanar reconstruction (3D-MPR) in severe mitral stenosis (MS) using 3D-TEE.Methods: 149 patients with severe MS who were referred for percutaneous transmitral commissurotomy (PTMC), prospectively recruited. All patients underwent 2D transthoracic echocardiography (2D-TTE) and 3D-TEE in a single session before PTMC. During 2D-TTE planimetry, pressure half time (PHT), and proximal isovelocity surface area (PISA) were applied to measure the MVA. Transmitral mean pressure gradient (MPG) was measured. During 3D-TEE, MVA planimetry was carried out with both 3D-direct and 3D-MPR methods. 3D-direct was applied from both atrial and ventricular views. The consistency of MVA measurements with 3D-direct, 3D-MPR, and 2D-TTE methods was statistically investigated.Results: Our sample consisted of 109 (73.2%) women and 40 (26.8%) men. The mean age was 51.75 ± 9.81 years. The agreement between 3D-direct and 3D-MPR planimetry was signi cant and moderate (0.99 ± 0.29 cm 2 vs. 1.12 ± 0.26 cm 2 , Intraclass Correlation = 0.716, p value =0.001).The accuracy of the 3Ddirect method reduced signi cantly compared to the MPR method at MVA > 1.5 cm 2 . The maximum difference between two methods was observed in cases with MVAs larger than 1.5 cm 2 . MVA measured with the 3D-MPR method was signi cantly correlated with a 2D-TTE method, with a moderate agreement (Intraclass Correlation = 0.644, p value = 0.001). Also, 2D-TTE and 3D-direct TEE techniques yielded signi cantly consistent measurements of the MVA (1.06 ± 0.026 cm 2 vs. 0.99 ± 0.29 cm 2 , Intraclass Correlation = 0.787, p value = 0.001); however, with a slight overestimation of the MVA by the former with a net difference of 0.06 ± 0.013 cm 2 . Mitral valve pressure gradient (MPG) had no signi cant correlation with planimetry results. A signi cant inverse correlation was seen between the MVA and pulmonary arterial systolic pressure.Conclusion: 3D-direct planimetry has an acceptable agreement with 3D-MPR planimetry at MVA less than 1.5 cm 2 , but their correlation decreases signi cantly at MVA above 1.5 cm 2 . 3D-direct planimetry underestimates MVA compared to 3D-MPR, especially at MVA above 1.5 cm 2 . The 2D-TTE planimetry has generally acceptable accuracy, but its correlation to the 3D-TEE methods is signi cantly reduced in cases with moderate to severe MS (i.e. MVA> 1.0cm2).

Introduction: Because of increasing the population of premature infants due to improving neonatal care we try to find other independent criteria in addition to birth weight and gestational age to reduce the number of infants who need a retinopathy of prematurity (ROP) screening examination. Methods: This is a retrospective cross-sectional study, included 150 preterm infants with gestational age of ≤ 32 weeks or birth weight ≤ 1500 g or receives oxygen therapy for more than 2 days, who were examined from the fourth week of life for ROP in Tabriz Al-Zahra hospital’s neonatal intensive care unit (NICU), from March 2017 to January 2018. All infants with other risk factors such as multi gestational pregnancy, blood transfusion or exchange, phototherapy, underlying disease, cerebral hemorrhage, chronic lung disease and sepsis were excluded from the study. Infants divided to two group ROP (n=47) and non-ROP (n=133) and their 5-minute Apgar score was Apgar score was compared as an independent risk factor. Exploratory data analysis was performed using descriptive measures with independent samples t tests. Kolmogorov-Smirnov tests were used to test the normality of data distribution. Results: The mean 5-minute Apgar scores were statistically lower in ROP group (5.4±2.3) than non-ROP group 6.2±2.1 (P value=0.041). Conclusion: Apgar score was statistically significant, but in light of the very close results obtained, it seems prudent to consider an independent risk factor.