Quantification of mitral regurgitation by automated cardiac output measurement: experimental and clinical validation

Sun, Jing Ping; Yang, Xing Sheng; Qin, Jian Xin; Greenberg, Neil L.; Zhou, Jingbo; Vázquez, C; Griffin, Brian P.; Stewart, William J.; Thomas, James D.

doi:10.1016/s0735-1097(98)00329-5

Cited by 22 publications

(14 citation statements)

References 41 publications

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“…For ultrasonography, pulsed wave, continuous wave, power Doppler, ACM, and 3D reconstruction flow methods have been reported. [1][2][3][4][7][8][9][10][11][12][21][22][23][24] Most commonly, such flows are determined from pulsed wave Doppler velocity data obtained from the centerline of flow, and the cross-sectional area of the annulus or vessel at this point obtained from the diameter measured from 2D ultrasonographic imaging. This single pulsed wave Doppler sample volume does not allow estimation of a velocity profile across the entire flow area but, by virtue of the limited lateral resolution, nonetheless probably obtains the spatial mean velocity.…”

Section: Previous Echo Methods Of Estimating Quantificationmentioning

confidence: 99%

“…The ACM method assumes axisymmetric flow; i.e., velocity information from 1 cross section is assumed to represent the entire flow profile. 20,21,23 However, the spatial distribution of the flow velocity depends on many factors, including the size and geometry of the vessel or valve in question and the flow volume. In the clinical setting, flow profiles may differ between axes because of dynamic changes in heart and vessel shape and size during the cardiac cycle.…”

Section: Previous Echo Methods Of Estimating Quantificationmentioning

confidence: 99%

“…13,[15][16][17] Recently, a new automated digital color Doppler-based cardiac output measurement (ACM) method has been described. [18][19][20][21][22][23][24] The method calculates flow profiles by the spatial and temporal integration of 2D digital color Doppler data within a user-positioned region of interest. However, this method is based on flow data obtained parallel to the flow and within a single 2D plane and an assumption of axial or hemiaxial symmetrical flow.…”

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Quantification of flow volume with a new digital three‐dimensional color Doppler flow approach: an in vitro study.

Mori

et al. 2001

J of Ultrasound Medicine

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Objective. The quantification of flow stroke volume is important for evaluation of patients with cardiac dysfunction and cardiovascular disease. Three-dimensional digital color Doppler flow imaging allows the acquisition of flow data in an orientation approximately parallel to flow and analysis of the Doppler flow velocities perpendicular to flow (cross-sectional flow calculation). This in vitro study assessed the applicability of this method for quantifying cardiac output in a funnel-shaped tube model similar to mitral inflow or the left ventricular outflow tract. Methods. A new digital three-dimensional color Doppler method was used to acquire Doppler flow information. Raw scan line data with digital velocity assignments were obtained on a conventional Doppler color flow imaging system with a 180°rotating multiplanar transesophageal probe connected to a computer workstation. Nine stroke volumes (20-60 mL) with flow rates ranging from 1.5 to 5.28 L/min in a funnel-shaped pulsatile laminar flow model were studied. Three-dimensional flow rates were compared with standard-of-reference measurements of flow obtained from timed collection in a graduated cylinder and with an ultrasonic flow meter. Results. Within the funnel tube, the flow volumes that were calculated from the first, second, and third depths and the average of all 3 depths correlated well with the actual flow rate (r = 0.97-0.99). Results from the middle and second levels and from the average of all 3 depths provided the closest fit to the actual flow rates (r = 0.99; y = 0.96x + 0.14; and r = 0.98; y = 1.14x -0.43, respectively). Conclusions. Although a work in progress, this digital three-dimensional color Doppler flow measurement method is feasible, accurate, and simple, and it may offer in vivo evaluation of blood volume flow given a favorable orientation between the valve orifice and the scanning device. Key words: three-dimensional echocardiography; digital color Doppler imaging; flow; angle independence. Abbreviations ACM, automated cardiac output measurement; MRI, magnetic resonance imaging; SEE, standard error of the estimate; TEE, transesophageal echo; 3D, three-dimensional; 2D, two-dimensional ccurate, noninvasive measurement of blood flow in the inflow and outflow tracts of the heart and great arteries continues to be an important clinical goal in the assessment of cardiac function, shunt flows in congenital cardiac defects, and regurgitation in the presence of valvular disease. [1][2][3][4][5][6][7][8][9][10][11][12] Noninvasive methods for the quantification of blood flow include magnetic resonance imaging (MRI) and combinations of M-mode and two-dimensional (2D) echocardiography and spectral Doppler flow. 13 Phase-encoded MRI velocity methods have been used for quantifying flow across

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Section: Previous Echo Methods Of Estimating Quantificationmentioning

confidence: 99%

Section: Previous Echo Methods Of Estimating Quantificationmentioning

confidence: 99%

mentioning

confidence: 99%

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Quantification of flow volume with a new digital three‐dimensional color Doppler flow approach: an in vitro study.

Mori

et al. 2001

J of Ultrasound Medicine

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“…Aortic outflow SV is calculated as CSA LVOT ×VTI LVOT . This method assumes that no aortic regurgitation is present and has been validated against other methods of MR quantification [20]. & Stress testing: In patients with chronic primary MR, exercise stress testing with Doppler echocardiography may be useful in asymptomatic patients with severe MR to establish symptom status and exercise capacity and in symptomatic patients where there is a discrepancy between symptoms and severity of MR at rest [9••].…”

Section: Transthoracic Echocardiographymentioning

confidence: 99%

Assessment of Mitral Valve Disease: A Review of Imaging Modalities

Motiwala

Delling

2015

Curr Treat Options Cardio Med

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Mitral valve disease (MVD) related to mitral valve prolapse (MVP), coronary artery disease (CAD), and calcific mitral stenosis, is increasing in prevalence across the USA and Europe in the context of a longer life expectancy and aging population. In developing countries, rheumatic heart disease remains a major cause of MVD. Echocardiography represents the primary diagnostic modality for assessment of the mitral valve (MV). With the implementation of three-dimensional imaging, echocardiography has become an indispensable tool to evaluate the morphology, geometry, and function of the MV apparatus in the pre-operative setting. However, recognition of its limitations and advances in newer technologies have led to a growing interest in other imaging modalities such as cardiac magnetic resonance (CMR). Although still not widely available, CMR is an essential complement to echocardiography, especially when poor image quality, significant variability in flow diameter measurements, and geometric assumptions of flow orifice preclude accurate quantification of mitral regurgitation on echocardiographic images. In addition, CMR can reliably provide quantitative determination of ventricular volumes and function, hence facilitating surgical decision-making when serial linear echocardiographic measurements are discrepant. Finally, CMR assessment of fibrosis using late gadolinium enhancement allows better understanding of the interactions between MVD and the myocardium in both MVP and MVD related to CAD or other myopathy. In this review, we summarize the role of the available imaging modalities in understanding valvular pathology and determining severity of regurgitation or stenosis. Recently published valvular guidelines highlight the importance of monitoring MVD progression and the shift to intervention earlier in the course of disease. In this context, we also discuss the potential role of echocardiography and CMR in identifying early stages of MVD and/or pre-clinical markers of myocardial dysfunction.

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“…Several echocardiographic applications have been proposed such as the quantification of aortic or mitral regurgitations [12][13][14][15]. Considering the difficulty to estimate pulmonary orifice area using conventional echocardiography, the aim of our prospective study was to validate the ACM method for the calculation of pulmonary output and the quantification of ICS in adults.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic automated cardiac output measurement of pulmonary output and quantification of intracardiac shunt

Mansencal

Martin

Farcot

et al. 2005

International Journal of Cardiology

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Quantification of mitral regurgitation by automated cardiac output measurement: experimental and clinical validation

Cited by 22 publications

References 41 publications

Quantification of flow volume with a new digital three‐dimensional color Doppler flow approach: an in vitro study.

Quantification of flow volume with a new digital three‐dimensional color Doppler flow approach: an in vitro study.

Assessment of Mitral Valve Disease: A Review of Imaging Modalities

Echocardiographic automated cardiac output measurement of pulmonary output and quantification of intracardiac shunt

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