Quantitative Assessment of Mitral Regurgitation

Shanks, Miriam; Siebelink, Hans‐Marc J.; Delgado, Victoria; Veire, Nico R. L. Van de; Ng, Arnold C.T.; Sieders, Allard; Schuijf, Joanne D.; Lamb, Hildo J.; Marsan, Nina Ajmone; Westenberg, Jos J.M.; Kroft, Lucia J.M.; Roos, Albert de; Bax, Jeroen J.

doi:10.1161/circimaging.110.947176

Cited by 128 publications

(31 citation statements)

References 33 publications

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“…8- 13 The current study extends these findings by showing high feasibility (91%) and reproducibility of the VCA measurement also during low-grade exercise, with a short image post-processing time <5 min. The feasibility of color Doppler 3-D echocardiography-derived VCA assessment has been related to the 2-D echocardiography image quality at rest.…”

Section: Feasibility and Reproducibilitysupporting

confidence: 76%

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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Section: Feasibility and Reproducibilitysupporting

confidence: 76%

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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“…VK alanının orta MY'yi ağır MY'den ayıran güvenilir "cut off" değeri 0,41cm 2 olarak bildirilmiştir. [19][20][21][23][24][25][26] Ishii ve ark.nın aort yetersizliği (AY)nde regürjitasyon miktarının saptanmasına yönelik yaptıkları çalışmada; regürjitan akım oranlarını belirlemede renkli Doppler jet alanı ve uzunluğu ölçümlerinin kullanımının kısıtlı olduğu; VK ölçü-münün, AY şiddetinin daha doğru bir belirleyicisi olduğu ve renkli Doppler VK genişlik ölçümünün spektral Doppler yöntemlerinden daha avantajlı olduğu gösterilmiştir. 27 Kapak yetersizliği olan hastalarda lezyon şid-detinin saptanmasında, kullanılan diğer bir yöntem PISA'dır.…”

Section: Discussionunclassified

Calculation of Left to Right Shunt by the Vena Contracta Method in Children with Ventricular Septal Defect

Paytoncu¹

2015

Turkiye Klinikleri J Cardiovasc Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Ventriküler septal defekt (VSD)'li hastaların klinik değerlendirmesinde soldan sağa şant miktarını belirlemek önemlidir. Bu çalışmada, VSD'li çocuklarda vena kontrakta (VK) yöntemi ile soldan sağa şant miktarının hesaplanması ve bu şekilde elde edilen sonuçların, farklı spektral Doppler yön-temler ile karşılaştırılması ve yöntemin uygulanabilirliğinin araştırılması amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Perimembranöz VSD'li 0,25-15,16 yaşları arasında, toplam 60 hasta çalışmaya alındı. Hastaların, renkli Doppler ekokardiyografi ile VK görüntülemeleri yapıldı. İki farklı spektral Doppler (Yön-tem I, II) ve VK yöntemi ile şant miktarları (Qp-Qs), şant volümleri (ŞV), şant oranları (Qp/Qs) hesaplandı. Farklı kardiyak sikluslarda en az altı farklı VK çapı ölçülerek, en geniş ölçüm hesaplamalarda kullanılmak üzere alındı. B Bu ul lg gu ul la ar r: : VK bulguları (ŞV, Qp-Qs ve Qp/Qs) ile spektral Doppler bulguları arasında olumlu yönde, oldukça güçlü derecede, istatistiksel olarak anlamlı ilişkiler bulundu. Fizyopatolojik sınıflandırmaya göre VK yöntemiyle saptanan bulguların, orta-geniş defektleri küçüklerden ayırt etmede faydalı olduğu görüldü (p<0,001). VK bulgularının sensitivite ve spesifisitesini tespit etmek için yapılan ROC analizinde yöntemin doğruluğunun yüksek olduğu bulundu (sırasıyla, 0,97, 0,90 ve 0,94). Orta-geniş VSD'leri tanımlamada VK bulguları (ŞV, Qp-Qs ve VK defekt alanı) için %90 sensitivite ve %90 spesifisite ile "cut-off" değerleri sırasıyla, 28,61 cm 3 /m 2 , 3,76 L/dk/m 2 ve 0,26 cm 2 /m 2 olarak bulundu. S So on nu uç ç: : VK yöntemi, küçük ve orta-geniş VSD'lerin noninvaziv olarak tanımlanmasında, diğer spektral Doppler yöntemlere yardımcı, güvenilir, kolay uygulanabilir semikantitatif bir yöntemdir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Kalp septum kusurları,ventriküler; ekokardiyografi, Doppler, renkli;hidrodinamikler; hemodinamikler A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : It is important to determine the amount of left to right shunt in the clinical evaluation of patients with ventricular septal defect (VSD). In this study, we aimed to estimate the left-to-right shunt in patients with VSD by measuring the vena contracta (VC) and to compare the findings of this method with other spectral Doppler methods and to assess the clinical feasibility of the VC method. M Ma a--t te er ri ia al l a an nd d M Me et th ho od ds s: : Sixty patients, aged 0.25-15.16 years were enrolled in the study. VC images of VSD flow were obtained with color Doppler echocardiography. Left-to-right shunt (Qp-Qs), shunt volume (SV) and pulmonary to systemic flow ratio (Qp/Qs) were calculated by two different spectral Doppler and by the VC methods. At least six measurements of VC diameter were obtained in different cardiac cycles and the largest measurement was used in calculation. R Re es su ul lt ts s: : There were statistically significant and positive correlations between the findings of vena contracta (SV, Qp-Qs ve Qp/Qs)...

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“…A variant of this approach employs PC-CMR to sample flow through the aortic valve (a region with lesser translational motion than the mitral valve), and cine-CMR to measure LV stroke volume (∆ end-diastole − end-systole); differential stroke volume corresponds to the amount of MR (Figure 1) (24). This method has been shown to correlate well with invasive measurements of MR via cardiac catheterization, as well as non-invasive measurement via echo (25)(26)(27). MR as quantified based on differential aortic and mitral valve forward stroke volume can be affected by concomitant aortic regurgitation.…”

Section: Quantification Of Mrmentioning

confidence: 99%

Utility of cardiac magnetic resonance for evaluation of mitral regurgitation prior to mitral valve surgery

et al. 2017

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Mitral regurgitation (MR) is a common cause of morbidity worldwide and an accepted indication for interventional therapies which aim to reduce or resolve adverse clinical outcomes associated with MR.Cardiac magnetic resonance (CMR) provides highly accurate means of assessing MR, including a variety of approaches that can measure MR based on quantitative flow. Additionally, CMR is widely accepted as a reference standard for cardiac chamber quantification, enabling reliable detection of subtle changes in cardiac chamber size and function so as to guide decision-making regarding timing of mitral valve directed therapies. Beyond geometric imaging, CMR enables tissue characterization of ischemia and infarction in the left ventricular (LV) myocardium as well as within the mitral valve apparatus, thus enabling identification of structural substrates for MR. This review provides an overview of established and emerging CMR approaches to measure valvular regurgitation, including relative utility of different approaches for patients with primary or secondary MR. Clinical outcomes studies are discussed with focus on data demonstrating advantages of CMR for guiding diagnosis, risk stratification, and management of patients with known or suspected MR. Comparative data is reviewed with focus on diagnostic performance of CMR in comparison to conventional assessment via echocardiography (echo). Emerging literature is reviewed concerning potential new approaches that utilize CMR tissue characterization to guide clinical decision-making in order to improve therapeutic outcomes and clinical prognosis for patients with MR. J Thorac Dis 2017;9(Suppl 4):S246-S256 jtd.amegroups.com pre-operative morbidity and decreases procedural efficacy (9,10), possibly due to impact of LV or left atrial (LA) dilation on mitral apparatus geometry or wall stress (11-13). Accordingly, consensus guidelines recommend surgery for patients with severe primary MR if symptoms are present or, in the case of asymptomatic individuals, if LV dysfunction (ejection fraction <60%) or chamber dilation (end-systolic diameter ≥40 mm) is present (14). Echocardiography (echo) is widely used to guide decision-making concerning timing of interventional therapies for MR (14). However, echo can be suboptimal for this purpose, as image quality can vary (15), chamber quantification is typically predicated on 2-dimensional (2D) geometric assumptions [rather than 3-dimensional (3D) imaging] (16), and MR quantification can be challenging in the context of regurgitant jet eccentricity (17). These limitations may explain recent data suggesting lack of correlation between pre-operative echo-quantified MR severity and LV reverse remodeling after mitral valve surgery (18). Knowledge gaps regarding predictors of procedural success limit the ability to optimize decision-making for patients with MR.Cardiac magnetic resonance (CMR) can assess MR as well as its predisposing risk factors. A variety of CMR pulse sequences can be used for MR assessment ( Table 1). Phase velocity en...

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Quantitative Assessment of Mitral Regurgitation

Cited by 128 publications

References 33 publications

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

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

Calculation of Left to Right Shunt by the Vena Contracta Method in Children with Ventricular Septal Defect

Utility of cardiac magnetic resonance for evaluation of mitral regurgitation prior to mitral valve surgery

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