Quantification of mitral valve apparatus by three-dimensional transesophageal echocardiography: in vitro validation study comparing two different analysis systems
Tóm tắt
Two commercial software systems have become available for quantitation of mitral leaflet and annulus geometry based on three-dimensional (3D) transesophageal echocardiographic (3DTEE) images. The aim of this study is to investigate the accuracy and compatibility of the three-dimensional (3D) measurements by Real View® and MVQ®. 3DTEE images were obtained from phantom models with saddle-shaped annulus of mitral valve prolapse and mitral valve tenting. From reconstructed 3D data, prolapse and tenting volume were calculated by both Real View® and MVQ® and compared with the actual volume. The volume of the phantom models with saddle-shaped annulus measured by Real View® (tenting r = 0.99, prolapse r = 0.99) and MVQ® (tenting r = 0.99, prolapse r = 0.99) showed good agreement with the actual volume. However, significant difference between Real View® and MVQ® was observed in the result of quantification (tenting 2.27 ± 1.5 ml versus 2.53 ± 1.6 ml, prolapse 2.55 ± 1.7 ml versus 2.31 ± 1.6 ml, both P < 0.05). Although the 2 commercially available systems allow accurate quantitative measurements of the 3D volume, discrepancy in the quantified value as a result of differences in the estimation of annular level is observed. Therefore, we should take into account the characteristics of each software when interpreting analytical results.
Tài liệu tham khảo
Macnab A, Jenkins NP, Bridgewater BJ, Hooper TL, Greenhalgh DL, Patrick MR, et al. Three-dimensional echocardiography is superior to multiplane transoesophageal echo in the assessment of regurgitant mitral valve morphology. Eur J Echocardiogr. 2004;5:212–22.
Barrea C, Levasseur S, Roman K, Nii M, Coles JG, Williams WG, et al. Three-dimensional echocardiography improves the understanding of left atrioventricular valve morphology and function in atrioventricular septal defects undergoing patch augmentation. J Thorac Cardiovasc Surg. 2005;129:746–53.
Sugeng L, Coon P, Weinert L, Jolly N, Lammertin G, Bednarz JE, et al. Use of real-time 3-dimensional transthoracic echocardiography in the evaluation of mitral valve disease. J Am Soc Echocardiogr. 2006;19:413–21.
Kuperstein R, Feinberg MS, Carasso S, Gilman S, Dror Z, Di Segni E. The added value of real-time 3-dimensional echocardiography in the diagnosis of isolated cleft mitral valve in adults. J Am Soc Echocardiogr. 2006;19:811–4.
Anwar AM, Soliman OI, Nemes A, Germans T, Krenning BJ, Geleijnse ML, et al. Assessment of mitral annulus size and function by real-time 3-dimensional echocardiography in cardiomyopathy: comparison with magnetic resonance imaging. J Am Soc Echocardiogr. 2007;20:941–8.
Sharma R, Mann J, Drummond L, Livesey SA, Simpson IA. The evaluation of real-time 3-dimensional transthoracic echocardiography for the preoperative functional assessment of patients with mitral valve prolapse: a comparison with 2-dimensional transesophageal echocardiography. J Am Soc Echocardiogr. 2007;20:934–40.
Garcia-Orta R, Moreno E, Vidal M, Ruiz-Lopez F, Oyonarte JM, Lara J, et al. Three-dimensional versus two-dimensional transesophageal echocardiography in mitral valve repair. J Am Soc Echocardiogr. 2007;20:4–12.
Yamaura Y, Yoshikawa J, Yoshida K, Hozumi T, Akasaka T, Okada Y. Three-dimensional analysis of configuration and dynamics in patients with an annuloplasty ring by multiplane transesophageal echocardiography: comparison between flexible and rigid annuloplasty rings. J Heart Valve Dis. 1995;4:618–22.
Yamaura Y, Yoshida K, Hozumi T, Akasaka T, Okada Y, Yoshikawa J. Three-dimensional echocardiographic evaluation of configuration and dynamics of the mitral annulus in patients fitted with an annuloplasty ring. J Heart Valve Dis. 1997;6:43–7.
Gillinov AM, Cosgrove DM 3rd, Shiota T, Qin J, Tsujino H, Stewart WJ, et al. Cosgrove–Edwards annuloplasty system: midterm results. Ann Thorac Surg. 2000;69:717–21.
Kwan J, Shiota T, Agler DA, Popovic ZB, Qin JX, Gillinov MA, et al. Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation: real-time three-dimensional echocardiography study. Circulation. 2003;107:1135–40.
Ahmad RM, Gillinov AM, McCarthy PM, Blackstone EH, Apperson-Hansen C, Qin JX, et al. Annular geometry and motion in human ischemic mitral regurgitation: novel assessment with three-dimensional echocardiography and computer reconstruction. Ann Thorac Surg. 2004;78:2063–8; discussion 2068.
Daimon M, Shiota T, Gillinov AM, Hayase M, Ruel M, Cohn WE, et al. Percutaneous mitral valve repair for chronic ischemic mitral regurgitation: a real-time three-dimensional echocardiographic study in an ovine model. Circulation. 2005;111:2183–9.
Watanabe N, Ogasawara Y, Yamaura Y, Kawamoto T, Toyota E, Akasaka T, et al. Quantitation of mitral valve tenting in ischemic mitral regurgitation by transthoracic real-time three-dimensional echocardiography. J Am Coll Cardiol. 2005;45:763–9.
Watanabe N, Ogasawara Y, Yamaura Y, Wada N, Kawamoto T, Toyota E, et al. Mitral annulus flattens in ischemic mitral regurgitation: geometric differences between inferior and anterior myocardial infarction: a real-time 3-dimensional echocardiographic study. Circulation. 2005;112:I458–62.
Watanabe N, Ogasawara Y, Saito K, Yamaura Y, Tsukihi M, Okahashi N, et al. Quantitation of the degree of mitral valve prolapse by novel insights from transthoracic real-time three-dimensional echocardiography. J Echocardiogr 2007;5:112–7.
Yang HS, Bansal RC, Mookadam F, Khandheria BK, Tajik AJ, Chandrasekaran K. Practical guide for three-dimensional transthoracic echocardiography using a fully sampled matrix array transducer. J Am Soc Echocardiogr 2008;21:979–89; quiz 1081–2.
Tsukiji M, Watanabe N, Yamaura Y, Okahashi N, Obase K, Neishi Y, et al. Three-dimensional quantitation of mitral valve coaptation by a novel software system with transthoracic real-time three-dimensional echocardiography. J Am Soc Echocardiogr. 2008;21:43–6.
Watanabe N, Ogasawara Y, Yamaura Y, Yamamoto K, Wada N, Kawamoto T, et al. Geometric differences of the mitral valve tenting between anterior and inferior myocardial infarction with significant ischemic mitral regurgitation: quantitation by novel software system with transthoracic real-time three-dimensional echocardiography. J Am Soc Echocardiogr. 2006;19:71–5.
Sonne C, Sugeng L, Watanabe N, Weinert L, Saito K, Tsukiji M, et al. Age and body surface area dependency of mitral valve and papillary apparatus parameters: assessment by real-time three-dimensional echocardiography. Eur J Echocardiogr. 2009;10:287–94.
Yamada R, Watanabe N, Kume T, Tsukiji M, Kawamoto T, Neishi Y, et al. Quantitative measurement of mitral valve coaptation in functional mitral regurgitation: In vivo experimental study by real-time three-dimensional echocardiography. J Cardiol. 2009;53:94–101.
Yamaura Y, Watanabe N, Ogasawara Y, Wada N, Kawamoto T, Toyota E, et al. Geometric change of mitral valve leaflets and annulus after reconstructive surgery for ischemic mitral regurgitation: real-time 3-dimensional echocardiographic study. J Thorac Cardiovasc Surg. 2005;130:1459–61.
Okahashi N, Watanabe N, Yamaura Y, Wada N, Neishi Y, Kawamoto T, et al. Noninvasive measurements of the mitral annulus geometry by newly-developed quantitation software with real-time three-dimensional echocardiography: a validation study. J Echocardiogr 2007;5:32–7.
Masuyama S, Marui A, Shimamoto T, Nonaka M, Tsukiji M, Watanabe N, et al. Chordal translocation for ischemic mitral regurgitation may ameliorate tethering of the posterior and anterior mitral leaflets. J Thorac Cardiovasc Surg. 2008;136:868–75.
Watanabe N, Ogasawara Y, Yamaura Y, Kawamoto T, Akasaka T, Yoshida K. Geometric deformity of the mitral annulus in patients with ischemic mitral regurgitation: a real-time three-dimensional echocardiographic study. J Heart Valve Dis. 2005;14:447–52.
de Varennes B, Chaturvedi R, Sidhu S, Cote AV, Shan WL, Goyer C, et al. Initial results of posterior leaflet extension for severe type IIIb ischemic mitral regurgitation. Circulation. 2009;119:2837–43.
Shingu Y, Yamada S, Ooka T, Tachibana T, Kubota S, Tsutsui H, et al. Papillary muscle suspension concomitant with approximation for functional mitral regurgitation. Circ J. 2009;73:2061–7.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.
Levine RA, Handschumacher MD, Sanfilippo AJ, Hagege AA, Harrigan P, Marshall JE, et al. Three-dimensional echocardiographic reconstruction of the mitral valve, with implications for the diagnosis of mitral valve prolapse. Circulation. 1989;80:589–98.
Levine RA, Weyman AE, Handschumacher MD. Three-dimensional echocardiography: techniques and applications. Am J Cardiol 1992;69:121H–30H; discussion 131H–4H.
Salgo IS, Gorman JH 3rd, Gorman RC, Jackson BM, Bowen FW, Plappert T, et al. Effect of annular shape on leaflet curvature in reducing mitral leaflet stress. Circulation. 2002;106:711–7.
Pai RG, Tanimoto M, Jintapakorn W, Azevedo J, Pandian NG, Shah PM. Volume-rendered three-dimensional dynamic anatomy of the mitral annulus using a transesophageal echocardiographic technique. J Heart Valve Dis. 1995;4:623–7.