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The International Journal of Cardiovascular Imaging

Erschienen in:

01.10.2007 | Original Article

True mitral annulus diameter is underestimated by two-dimensional echocardiography as evidenced by real-time three-dimensional echocardiography and magnetic resonance imaging

verfasst von: Ashraf M. Anwar, Osama I. I. Soliman, Folkert J. ten Cate, Attila Nemes, Jackie S. McGhie, Boudewijn J. Krenning, Robert-Jan van Geuns, Tjebbe W. Galema, Marcel L. Geleijnse

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 5/2007

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Abstract

Background

Mitral annulus assessment is of great importance for the diagnosis and treatment of mitral valve disease. The present study sought to assess the value of real-time three-dimensional echocardiography for the assessment of true mitral annulus diameter (MAD).

Methods

One hundred and fifty patients (mean age 38 ± 18 years) with adequate two-dimensional (2D) echocardiographic image quality underwent assessment of MAD_2D and MAD_3D (with real-time three-dimensional echocardiography). In a subgroup of 30 patients true MAD was validated with magnetic resonance imaging (MRI).

Results

There was a good interobserver agreement for MAD_2D (mean difference = −0.25 ± 2.90 mm, agreement: −3.16, 2.66) and MAD_3D (mean difference = 0.29 ± 2.03, agreement = −1.74, 2.32). Measurements of MAD_2D and MAD_3D were well correlated (R = 0.81, P < 0.0001). However, MAD_3D was significantly larger than MAD_2D (3.7 ± 0.9 vs. 3.3 ± 0.8 cm, P < 0.0001). In the subgroup of 30 patients with MRI validation, MAD_3D and MAD_MRI were significantly larger than MAD_2D (3.3 ± 0.5 and 3.4 ± 0.5 cm vs. 2.9 ± 0.4 cm, both P < 0.001). There was no significant difference between MAD_MRI and MAD_3D.

Conclusion

MAD_3D can be reliably measured and is superior to MAD_2D in the assessment of true mitral annular size.

Timek TA, Dagum P, Lai DT, Liang D, Daughters GT, Ingels NB Jr, Miller DC (2001) Pathogenesis of mitral regurgitation in tachycardia-induced cardiomyopathy. Circulation 104:I47–I53PubMed

Ho SY (2002) Anatomy of the mitral valve. Heart 88 Suppl 4:iv5–iv10

Boudoulas H, Wooley CF (2001) Floppy mitral valve, mitral valve prolapse, and mitral valvular regurgitation. Curr Treat Options Cardiovasc Med 3:15–24PubMedCrossRef

De Simone R, Wolf I, Mottl-Link S, Hoda R, Mikhail B, Sack FU, Meinzer HP, Hagl S (2006) A clinical study of annular geometry and dynamics in patients with ischemic mitral regurgitation: new insights into asymmetrical ring annuloplasty. Eur J Cardiothorac Surg 29:355–361PubMedCrossRef

Mihalatos DG, Mathew ST, Gopal AS, Joseph S, Grimson R, Reichek N (2006) Relationship of mitral annular remodeling to severity of chronic mitral regurgitation. J Am Soc Echocardiogr 19:76–82PubMedCrossRef

Gorman JH 3rd, Gupta KB, Streicher JT, Gorman RC, Jackson BM, Ratcliffe MB, Bogen DK, Edmunds LH Jr (1996) Dynamic three-dimensional imaging of the mitral valve and left ventricle by rapid sonomicrometry array localization. J Thorac Cardiovasc Surg 112:712–726PubMedCrossRef

Komoda T, Hetzer R, Uyama C, Siniawski H, Maeta H, Rosendahl UP, Ozaki K (1994) Mitral annular function assessed by 3D imaging for mitral valve surgery. J Heart Valve Dis 3:483–490PubMed

Cosgrove DM 3rd, Arcidi JM, Rodriguez L, Stewart WJ, Powell K, Thomas JD (1995) Initial experience with the Cosgrove–Edwards Annuloplasty System. Ann Thorac Surg 60:499–503, discussion 503–504

Pai RG, Tanimoto M, Jintapakorn W, Azevedo J, Pandian NG, Shah PM (1995) Volume-rendered three-dimensional dynamic anatomy of the mitral annulus using a transesophageal echocardiographic technique. J Heart Valve Dis 4:623–627PubMed

10.

Yamaura Y, Yoshikawa J, Yoshida K, Hozumi T, Akasaka T, Okada Y (1995) 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 4:618–622PubMed

11.

Kaji S, Nasu M, Yamamuro A, Tanabe K, Nagai K, Tani T, Tamita K, Shiratori K, Kinoshita M, Senda M, Okada Y, Morioka S (2005) Annular geometry in patients with chronic ischemic mitral regurgitation: three-dimensional magnetic resonance imaging study. Circulation 112:I409–I414PubMed

12.

Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMed

13.

Enriquez-Sarano M, Basmadjian AJ, Rossi A, Bailey KR, Seward JB, Tajik AJ (1999) Progression of mitral regurgitation: a prospective Doppler echocardiographic study. J Am Coll Cardiol 34:1137–1144PubMedCrossRef

14.

Srichai MB, Grimm RA, Stillman AE, Gillinov AM, Rodriguez LL, Lieber ML, Lara A, Weaver JA, McCarthy PM, White RD (2005) Ischemic mitral regurgitation: impact of the left ventricle and mitral valve in patients with left ventricular systolic dysfunction. Ann Thorac Surg 80:170–178PubMedCrossRef

15.

Czer LS, Maurer G, Bolger AF, DeRobertis M, Chaux A, Matloff JM (1996) Revascularization alone or combined with suture annuloplasty for ischemic mitral regurgitation. Evaluation by color Doppler echocardiography. Tex Heart Inst J 23:270–278PubMed

16.

Baba H, Okawa Y, Koike S, Hashimoto M, Matsumoto K (1997) [The causes and management of ischemic mitral regurgitation] Nippon Kyobu Geka Gakkai Zasshi 45:543–549

17.

Maniu CV, Patel JB, Reuter DG, Meyer DM, Edwards WD, Rihal CS, Redfield MM (2004) Acute and chronic reduction of functional mitral regurgitation in experimental heart failure by percutaneous mitral annuloplasty. J Am Coll Cardiol 44:1652–1661PubMedCrossRef

18.

Ma L, Tozzi P, Huber CH, Taub S, Gerelle G, von Segesser LK (2005) Double-crowned valved stents for off-pump mitral valve replacement. Eur J Cardiothorac Surg 28:194–8, discussion 198–199

19.

Webb JG, Harnek J, Munt BI, Kimblad PO, Chandavimol M, Thompson CR, Mayo JR, Solem JO (2006) Percutaneous transvenous mitral annuloplasty: initial human experience with device implantation in the coronary sinus. Circulation 113:851–855PubMedCrossRef

20.

Ghosh P, Bhonsle N (1999) Inaccuracy of prediction of mitral valve prosthesis size. Asian Cardiovasc Thorac Ann 7:190–194

21.

Yiu SF, Enriquez-Sarano M, Tribouilloy C, Seward JB, Tajik AJ (2000) Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction: a quantitative clinical study. Circulation 102:1400–1406PubMed

22.

Flachskampf FA, Chandra S, Gaddipatti A, Levine RA, Weyman AE, Ameling W, Hanrath P, Thomas JD (2000) Analysis of shape and motion of the mitral annulus in subjects with and without cardiomyopathy by echocardiographic 3-dimensional reconstruction. J Am Soc Echocardiogr 13:277–287PubMedCrossRef

23.

Timek TA, Miller DC (2001) Experimental and clinical assessment of mitral annular area and dynamics: what are we actually measuring? Ann Thorac Surg 72:966–974PubMedCrossRef

Titel: True mitral annulus diameter is underestimated by two-dimensional echocardiography as evidenced by real-time three-dimensional echocardiography and magnetic resonance imaging
verfasst von: Ashraf M. Anwar
Osama I. I. Soliman
Folkert J. ten Cate
Attila Nemes
Jackie S. McGhie
Boudewijn J. Krenning
Robert-Jan van Geuns
Tjebbe W. Galema
Marcel L. Geleijnse
Publikationsdatum: 01.10.2007
Verlag: Springer Netherlands
Erschienen in: The International Journal of Cardiovascular Imaging / Ausgabe 5/2007
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-006-9181-9

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True mitral annulus diameter is underestimated by two-dimensional echocardiography as evidenced by real-time three-dimensional echocardiography and magnetic resonance imaging