Dynamic Indices of Mitral Valve Function Using Perioperative Three-Dimensional Transesophageal Echocardiography

被引：21

作者：

Bartels, Karsten ^{[1
]}

Thiele, Robert H. ^{[1
,2
]}

Phillips-Bute, Barbara ^{[1
]}

Glower, Donald D. ^{[3
]}

Swaminathan, Madhav ^{[1
]}

Kisslo, Joseph ^{[4
]}

Mackensen, G. Burkhard ^{[5
]}

机构：

[1] Duke Univ, Med Ctr, Dept Anesthesiol, Div Cardiothorac Anesthesiol & Crit Care Med, Durham, NC USA

[2] Univ Virginia, Sch Med, Dept Anesthesiol, Charlottesville, VA 22908 USA

[3] Duke Univ, Med Ctr, Dept Surg, Div Cardiovasc & Thorac Surg, Durham, NC 27710 USA

[4] Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA

[5] Univ Washington, Dept Anesthesiol & Pain Med, Div Cardiothorac Anesthesiol, Seattle, WA 98195 USA

来源：

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA | 2014年 / 28卷 / 01期

关键词：

echocardiography; ultrasound; mitral valve; perioperative; computer applications; 2D TEE; 3D TEE; dynamic indices; ANNULAR GEOMETRY; REGURGITATION; QUANTIFICATION; ANNULOPLASTY; SEVERITY; REPAIR; RECOMMENDATIONS; COMPLEXITY; GUIDELINES; ACCURACY;

D O I：

10.1053/j.jvca.2013.03.024

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Objective: Perioperative transesophageal echocardiography is essential for decision-making for mitral valve surgery. While two-dimensional transesophageal echocardiography represents the standard of care, tracking of dynamic changes using three-dimensional imaging permits assessment of morphologic and functional characteristics of the mitral valve. The authors hypothesized that quantitative three-dimensional analysis would reveal distinct differences among diseased, repaired, and normal mitral valves. Design: Case-control observational clinical study. Setting: Tertiary care hospital. Participants: Using novel mitral valve quantification software, the authors retrospectively analyzed 80 datasets of cardiac surgery patients who underwent intraoperative transesophageal echocardiographic imaging. Twenty patients with degenerative mitral regurgitation were evaluated before and after mitral valve repair. Twenty patients had functional mitral regurgitation, and 20 patients had no mitral valve disease. Measurements and Main Results: Primary outcome measures of dynamic mitral valve function were: 1) three-dimensional annulus area, 2) annular displacement distance, 3) annular displacement velocity, and 4) annular area fraction. Other mitral annular tracking indices, in addition to intraobserver reliability and interobserver agreement, also were reported. Annulus area was enlarged in degenerative and functional mitral regurgitation. Annular displacement distance was decreased in functional mitral regurgitation and repaired valves. Annular displacement velocity was decreased in functional mitral regurgitation. Annular area fraction was decreased in functional mitral regurgitation and repaired valves. Intraobserver reliability and interobserver agreement were high for all 4 analyzed indices. Conclusions: Normal, functional regurgitant, degenerative, and repaired mitral valves have distinctly different dynamic signatures of anatomy and function as reliably determined by perioperative echocardiographic tracking. (c) 2014 Elsevier Inc. All rights reserved.

引用

页码：18 / 24

页数：7