Quantitation of valve regurgitation severity by three‐dimensional vena contracta area is superior to flow convergence method of quantitation on transesophageal echocardiography

Background Quantitation of regurgitation severity using the proximal isovelocity acceleration (PISA) method to calculate effective regurgitant orifice (ERO) area has limitations. Measurement of three‐dimensional (3D) vena contracta area (VCA) accurately grades mitral regurgitation (MR) severity on t...

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Bibliographic Details
Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2017-07, Vol.34 (7), p.992-1001
Main Authors: Abudiab, Muaz M., Chao, Chieh‐Ju, Liu, Shuang, Naqvi, Tasneem Z.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
color Doppler three‐dimensional
Echocardiography, Three-Dimensional - methods
Echocardiography, Transesophageal - methods
Female
Humans
Male
Middle Aged
mitral regurgitant jet area
Mitral Valve - diagnostic imaging
Mitral Valve - physiopathology
Mitral Valve Insufficiency - diagnostic imaging
Mitral Valve Insufficiency - physiopathology
PISA
Reproducibility of Results
Severity of Illness Index
three‐dimensional transesophageal echocardiography
Young Adult
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Summary:Background Quantitation of regurgitation severity using the proximal isovelocity acceleration (PISA) method to calculate effective regurgitant orifice (ERO) area has limitations. Measurement of three‐dimensional (3D) vena contracta area (VCA) accurately grades mitral regurgitation (MR) severity on transthoracic echocardiography (TTE). Methods We evaluated 3D VCA quantitation of regurgitant jet severity using 3D transesophageal echocardiography (TEE) in 110 native mitral, aortic, and tricuspid valves and six prosthetic valves in patients with at least mild valvular regurgitation. The ASE‐recommended integrative method comprising semiquantitative and quantitative assessment of valvular regurgitation was used as a reference method, including ERO area by 2D PISA for assigning severity of regurgitation grade. Results Mean age was 62.2±14.4 years; 3D VCA quantitation was feasible in 91% regurgitant valves compared to 78% by the PISA method. When both methods were feasible and in the presence of a single regurgitant jet, 3D VCA and 2D PISA were similar in differentiating assigned severity (ANOVAP
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.13549