Broad-beam spectral Doppler sonification of the vena contracta using matrix-array technology

Buck, Thomas; Plicht, Björn; Hunold, Peter; Mucci, Ronald A.; Erbel, Raimund; Levine, Robert A.

doi:10.1016/j.jacc.2004.11.036

Cited by 26 publications

(6 citation statements)

References 43 publications

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“…However, several studies have used RVol obtained by phase contrast velocity mapping by CMR as a reference method to compare various 2D and 3D echocardiographic techniques to evaluate MR severity [6,8,16,17]. …”

Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular volumes and primary mitral regurgitation severity by 2D echocardiography and cardiovascular magnetic resonance

Heyning

Magné

Piérard

et al. 2013

Cardiovasc Ultrasound

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BackgroundTwo-dimensional transthoracic echocardiography (2DTTE) remains the first-line diagnostic imaging tool to assess primary mitral regurgitation although cardiovascular magnetic resonance (CMR) has proven to establish left ventricular function more accurately and might evaluate mitral regurgitation severity more reliably. We sought to compare routine evaluation of left ventricular function and mitral regurgitation severity by 2DTTE with assessment by CMR in moderate to severe primary mitral regurgitation without overt left ventricular dysfunction.MethodsWe prospectively included 38 patients (79% of male, age 57 ± 14 years) with at least moderate primary mitral regurgitation, a left ventricular ejection fraction ≥60% and a left ventricular end-systolic diameter ≤45 mm. Patients with evidence of coronary artery disease, arrhythmias or significant concomitant valvular disease were excluded. All patients were scheduled for 2DTTE and CMR.ResultsLeft ventricular end-diastolic and end-systolic volumes were significantly underestimated by 2DTTE in comparison with CMR, although there was a strong correlation (Pearson r = 0.81, p < 0.00001 and r = 0.7, p < 0.00001, respectively). Measurement of the regurgitant orifice was similar between 2DTTE PISA method and planimetry by CMR (47 ± 24 vs. 42 ± 16 mm2, p = 0.12) with a strong correlation between both imaging techniques (Pearson r = 0.76, p < 0.0001). By contrast, assessment of the regurgitant volume by 2DTTE and by phase contrast velocity mapping by CMR showed poor agreement.ConclusionsIn moderate to severe primary mitral regurgitation without overt left ventricular dysfunction, 2DTTE significantly underestimates left ventricular remodelling in comparison to CMR. Measurement of the regurgitant orifice with planimetry by CMR shows good agreement with the PISA method by 2DTTE and thus may be a valuable alternative to assess mitral regurgitation severity.

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Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular volumes and primary mitral regurgitation severity by 2D echocardiography and cardiovascular magnetic resonance

Heyning

Magné

Piérard

et al. 2013

Cardiovasc Ultrasound

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“…The method combines trans thoracic 3-D high framerate acquisitions and unfocused beams to perform jet area segmentation and velocity estimation at the jet core from a single recording. The proposed method does not require a preliminary calibration procedure as in [25], [43]- [45] and does not require Color Flow recordings at the inflow region as in the PISA method. Moreover, flow rate estimation is performed autonomously at multiple frames throughout the regurgitation phase.…”

Section: Discussionmentioning

confidence: 99%

“…Once the jet CSA is known, the instantaneous flow rate and RVol can be calculated by multiplying the jet CSA by the Velocity Time Integral (VTI) from CW Doppler. This method was investigated in vivo using single beam, focused, high PRF (HPRF) acquisitions [43]- [45].…”

Section: Introductionmentioning

confidence: 99%

Quantification of Flow Rates and Flow Volumes in Valve Regurgitation Using 3-D High Frame-Rate Ultrasound

Fiorentini

Berg

Torp

et al. 2023

IEEE Open J. Ultrason., Ferroelect., Freq. Contr.

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Valve regurgitation is a cardiac condition caused by the incomplete closure of a cardiac valve. Untreated, this condition may result in cardiac failure. Regular monitoring of this condition is essential in guiding the decision process for surgical intervention. Current guidelines recommend a multiparametric assessment of valve regurgitation using echocardiography, which is both time consuming and heavily dependent on the experience of the examiner. Several methods have been proposed to provide quantitative markers to facilitate the assessment of valve regurgitation, most notably the Proximal Isovelocity Surface Area (PISA) method and methods based on the quantification of the total Regurgitant Volume (RVol) from the power of backscattered blood signal. In this work, we propose a framework based on trans-thoracic 3-D high framerate acquisitions for the simultaneous estimation of the jet crosssectional area and jet velocity directly at the jet core, which are then combined to estimate the instantaneous flow rate and RVol patients with aortic or mitral insufficiency. We compare two methods for the segmentation of the jet cross-sectional area from the power Doppler signal. Validation on simulated data indicates good segmentation accuracy for the best method (β = 0.97, R 2 = 0.91). Validation on recordings from a flow phantom shows good agreement (β = 1.2, R 2 = 0.88) with an external flow rate meter. Clinical feasibility of the method is also shown in a patient with mitral regurgitation.

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“…However, it remains unclear whether future automated methods will be based on color Doppler data anyway as they only provide limited spatial and temporal resolution as well as limited accuracy of velocities due to autocorrelation processing. Ultimately, future flow quantification methods might be based on different source data like volumetric spectral Doppler data (as used by the backscattered power-velocity integral method) [ 54 , 55 ] or vector flow analysis [ 56 ] for example.…”

Section: Future Perspectivesmentioning

confidence: 99%

Real-Time Three-Dimensional Echocardiographic Assessment of Severity of Mitral Regurgitation Using Proximal Isovelocity Surface Area and Vena Contracta Area Method. Lessons We Learned and Clinical Implications

Buck

Plicht

2015

Curr Cardiovasc Imaging Rep

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Mitral regurgitation (MR) is considered the most common valve disease with a prevalence of 2–3 % of significant regurgitation (moderate to severe and severe) in the general population. Accurate assessment of the severity of regurgitation was demonstrated to be of significant importance for patient management and prognosis and consequently has been widely recognized in recent guidelines. However, evaluation of severity of valvular regurgitation can be potentially difficult with the largest challenges presenting in cases of mitral regurgitation. Real-time three-dimensional echocardiography (RT3DE) by the use of color Doppler has the potential to overcome the limitations of conventional flow quantification using 2D color Doppler methods. Recent studies validated the application of color Doppler RT3DE for the assessment of flow based on vena contracta area (VCA) and proximal isovelocity surface area (PISA). Particularly, the assessment of VCA by color Doppler RT3DE led to a change of paradigm by understanding the VCA as being strongly asymmetric in the majority of patients and etiologies. In this review, we provide a discussion of the current state of clinical evaluation, limitations, and future perspectives of the two methods and their presentation in recent literature and guidelines.

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Broad-beam spectral Doppler sonification of the vena contracta using matrix-array technology

Abstract: The broad-beam spectral Doppler technique provides accurate, largely automated quantification of regurgitant flow rate and integrated RSV directly at the lesion. The accuracy related to broader sonification is made possible by the new matrix-array transducer design.

Cited by 26 publications

References 43 publications

Assessment of left ventricular volumes and primary mitral regurgitation severity by 2D echocardiography and cardiovascular magnetic resonance

Assessment of left ventricular volumes and primary mitral regurgitation severity by 2D echocardiography and cardiovascular magnetic resonance

Quantification of Flow Rates and Flow Volumes in Valve Regurgitation Using 3-D High Frame-Rate Ultrasound

Real-Time Three-Dimensional Echocardiographic Assessment of Severity of Mitral Regurgitation Using Proximal Isovelocity Surface Area and Vena Contracta Area Method. Lessons We Learned and Clinical Implications

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