Quantitative assessment of primary mitral regurgitation using left ventricular volumes: a three-dimensional transthoracic echocardiographic pilot study

被引:12
作者
Marechaux, Sylvestre [1 ,2 ]
Le Goffic, Caroline [1 ]
Ennezat, Pierre-Vladimir [3 ]
Semichon, Marc [1 ]
Castel, Anne-Laure [1 ]
Delelis, Francois [1 ]
Lemahieu, Jean Michel [1 ]
Menet, Aymeric [1 ]
Graux, Pierre [1 ]
Tribouilloy, Christophe [2 ,4 ]
机构
[1] Univ Catholique Lille, Cardiol Dept, GCS Grp Hop Inst Catholique Lille,Fac Libre Med, Univ Lille Nord France,Serv Cardiol & Soins Inten, F-59160 Lomme Les Lille, France
[2] Univ Picardie, INSERM, U1088, Amiens, France
[3] CHU Grenoble, F-38043 Grenoble, France
[4] Ctr Hosp Univ Amiens, Amiens, France
关键词
Three-dimensional echocardiography; three-dimensional left ventricular volumes; primary mitral regurgitation; valvular heart disease; NATIVE VALVULAR REGURGITATION; CARDIAC MAGNETIC-RESONANCE; WALL-MOTION ABNORMALITIES; DOPPLER-ECHOCARDIOGRAPHY; HEART-DISEASE; RECOMMENDATIONS; ACCURACY; REPRODUCIBILITY; VALIDATION; SEVERITY;
D O I
10.1093/ehjci/jeu091
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims To investigate the value of assessment of mitral regurgitant fraction (RF) using left ventricular (LV) volumes obtained by three-dimensional echocardiography (3DE) to quantify primary mitral regurgitation (MR). Methods and results Sixty patients with primary MR in sinus rhythm were prospectively enrolled. RF was calculated using either 2DE or 3DELV volumes obtained as follows: (LV total stroke volume - LV forward stroke volume by Doppler)/LV total stroke volume. Severity of MR was graded independently by two cardiologists blinded to LV volumetric data using an integrative approach, as recommended by current guidelines. Sixty patients with LV ejection fraction >50% and no MR were also studied. In patients without MR, 3D total LV stroke volume was more strongly correlated with LV forward stroke volume than 2D total LV stroke volume (r = 0.75, P < 0.0001 vs. r = 0.62, P < 0.0001, respectively). The 3D method had a feasibility of 90% in patients with MR. Inter-reader concordance for MR grading (four grades) was excellent with a Kappa-value of 0.90, P < 0.0001. A significant correlation was observed between grade of MR severity and 3D RF (r = 0.83, P < 0.0001) and 2D RF (r = 0.74, P < 0.0001). Comparisons between individual grades for 3D RF were significant (P < 0.05) except for 3+ vs. 4+ MR(P = 0.213). All patients with 3D RF >= 40% had >= 3+ or 4+ MR and those with 3D RF <= 30% had 1+ or 2+ MR with a 'grey' overlap zone between 30 and 40%. Conclusions RF can be routinely determined using 3D LV volumes with a high feasibility in patients with primary MR and is reliable for identification of Grade 3+ or Grade 4+ MR. The incorporation of this parameter into the currently recommended multiparametric integrative approach might be helpful to discriminate significant MR.
引用
收藏
页码:1133 / 1139
页数:7
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