Quantification of Aortic Valve Area Using Three-Dimensional Echocardiography

Three-Dimensional-Wall Motion Tracking: A New and Faster Tool for Myocardial Strain Assessment: Comparison With Two-Dimensional-Wall Motion Tracking

“…That is why the 3D format more closely represents reality than the 2D format, not only in the assessment of LV function but also in the diagnosis of valvular or myocardial diseases. [10][11][12] Cardiac motion is 3D, so 2D WMT is limited because it cannot assess movement in the third dimension. That is the main difference between 2D and 3D WMT: 2D WMT tracks 2D movement (or the projection of 3D movement) onto a 2D plane.…”

Classical methods to measure aortic valve area in the era of new invasive therapies: still accurate enough?

“…This study, along with the aforementioned studies [17][18][19], indicates the potential errors that can be made in aortic valve area calculation by considering circular geometry of the LVOT. In aortic stenosis patients, the accurate estimate of the aortic valve area is crucial since the therapeutic decision depends not only on the presence of symptoms but also on the severity of the aortic stenosis.…”

“…Previous work by Burgstahler et al [19], demonstrated, with the use of magnetic resonance imaging, the elliptical shape of the LVOT in patients with and without aortic stenosis. In addition, two studies used 3D echocardiography and confirmed the elliptical geometry of the LVOT in patients with varying degrees of aortic stenosis, being more pronounced in those patients with basal septal hypertrophy [17,18]. Consequently, the aortic valve area calculated by 3D echocardiography, taking into account the elliptical geometry of the LVOT, agreed better with the anatomical standard used as a reference (aortic valve area calculated by 3D planimetry), whereas the 2D continuity equation consistently underestimated the aortic valve area [17,18].…”

“…In addition, two studies used 3D echocardiography and confirmed the elliptical geometry of the LVOT in patients with varying degrees of aortic stenosis, being more pronounced in those patients with basal septal hypertrophy [17,18]. Consequently, the aortic valve area calculated by 3D echocardiography, taking into account the elliptical geometry of the LVOT, agreed better with the anatomical standard used as a reference (aortic valve area calculated by 3D planimetry), whereas the 2D continuity equation consistently underestimated the aortic valve area [17,18]. This finding has important clinical implications, since patients with aortic stenosis may have different grades of severity depending on the method used to calculate the aortic valve area and, subsequently, the therapeutic management may change.…”

“…Current 3-dimensional (3D) imaging techniques enable the exact characterization of the LVOT geometry and avoid the geometrical assumptions subjected to 2D continuity equation [17,18]. Previous work by Burgstahler et al [19], demonstrated, with the use of magnetic resonance imaging, the elliptical shape of the LVOT in patients with and without aortic stenosis.…”