Quantitation of Mitral Regurgitation

Grayburn, Paul A.; Weissman, Neil J.; Zamorano, José Luís

doi:10.1161/circulationaha.112.121590

Cited by 151 publications

(87 citation statements)

References 117 publications

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“…3D-TEE has been used extensively for MA assessment 13,[16][17][18][19][20][21][22] ; however, its utility in assessing the proposed D-shaped MA, Figure 4. A, Medial and lateral trigones are identified using both short-and long axis planes.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Mak

Blanke

Ong

et al. 2016

Circ: Cardiovascular Imaging

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Background-Previously, through the use of computed tomography (CT), it has been proposed that D-shaped versus saddleshaped mitral annulus (MA) segmentation is more biomechanically appropriate to determine transcatheter mitral valve implantation size and eligibility. Methods and Results-Forty-one patients with severe mitral regurgitation being considered for transcatheter mitral valve implantation who had undergone cardiac CT and 3-dimensional transesophageal echocardiography (3D-TEE) were retrospectively evaluated. A standardized segmentation protocol for the D-shaped MA was developed using Philips Q-Laboratory mitral valve quantification software. MA dimensions were compared using Spearman's rank correlation and Bland-Altman analysis. Inter-and intraobserver agreement was quantified by intraclass correlation coefficient and Bland-Altman analysis. Mean age was 77±14 years; 71% male (n=29); mitral regurgitation pathogenesis was functional in 54% (n=22) and myxomatous in 46% (n=19

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Mak

Blanke

Ong

et al. 2016

Circ: Cardiovascular Imaging

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“…The irregular hemi-elliptical shape of ERO is relatively common in FMR. 16 Asymmetric ERO leads to underestimation of FMR severity by commonly used 2-D methods, such as PISA or vena contracta width. 8-13,16,17 In contrast, the 3-D technique used in the current study allows direct visualization of ERO with precise assessment of its area and longest diameter and gives better results as reflected by AUC for VCA, ERO (PISA) and VCA increase during exercise (Figure 3).…”

Section: Vca At Rest and Clinical Outcomementioning

confidence: 99%

Three-Dimensional Echocardiography-Derived Vena Contracta Area at Rest and Its Increase During Exercise Predicts Clinical Outcome in Mild-Moderate Functional Mitral Regurgitation

Večeřa

Bartúnek

Vanderheyden

et al. 2014

Circ J

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“…28 Despite the use of expert core laboratory facilities and a standardized guidelinesbased approach, 18,29 MR quantification can be challenging after MitraClip placement. It is possible that the small decrease in LV volumes seen even in patients with residual 3 to 4+ MR reflects a small decrease in regurgitant volume that is sufficient to reduce LV volumes without changing MR grade to 2+ or better.…”

Section: Limitationsmentioning

confidence: 99%

Relationship Between the Magnitude of Reduction in Mitral Regurgitation Severity and Left Ventricular and Left Atrial Reverse Remodeling After MitraClip Therapy

et al. 2013

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Background-MitraClip has been shown to reduce mitral regurgitation (MR) severity safely but to a lesser degree than surgery. No data exist on the magnitude of MR reduction necessary to reverse left ventricular (LV) and left atrial (LA) dilation in patients with severe MR. Therefore, an analysis was performed to evaluate the relationship between MR reduction and LV and LA volumes after MitraClip therapy. Methods and Results-A total of 801 patients treated with MitraClip and 80 patients treated surgically were included. All patients had severe (3-4+) MR. MR severity, LV volumes at end-diastole and end-systole, and LA volumes were measured at baseline, discharge, 30 days, 6 months, and 1 year by an independent echocardiographic core laboratory. A linear repeated measures model was developed to determine the relationship between MR severity and time of measurement postindex procedure on longitudinal LV and LA volumes. Separate models were fit for functional MR and degenerative MR. In both degenerative and functional MR, reduction in LV volumes at end-diastole was associated with degree of residual MR at 12 months (P<0.0001). LV volumes at end-systole was significantly reduced in functional MR but not degenerative MR. LA volumes were significantly related to reduction of MR severity in both groups. Conclusions-Reduction of LV volumes at end-diastole and LA volumes, but not LV volumes at end-systole in degenerative MR, is consistent with correction of volume overload from primary MR. Reduction of all 3 measurements in functional MR demonstrates reverse remodeling when MR severity is reduced to either 1+ or 2+ by MitraClip therapy. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00209274.

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Quantitation of Mitral Regurgitation

Cited by 151 publications

References 117 publications

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Three-Dimensional Echocardiography-Derived Vena Contracta Area at Rest and Its Increase During Exercise Predicts Clinical Outcome in Mild-Moderate Functional Mitral Regurgitation

Relationship Between the Magnitude of Reduction in Mitral Regurgitation Severity and Left Ventricular and Left Atrial Reverse Remodeling After MitraClip Therapy

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