Three-dimensional continuity equation improved regurgitant volume assessment accuracy compared to diameter-based continuity equation, reducing overestimation by 19 mL in MVP patients.
Does the three-dimensional continuity equation (3D-CE) improve the accuracy of mitral regurgitant volume quantification compared to conventional methods and CMR in patients with mitral valve prolapse?
Incorporating 3D annular measurements into the continuity equation improves agreement with CMR for quantifying mitral regurgitation in mitral valve prolapse, mitigating the overestimation seen with conventional 2D methods.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Quantifying mitral regurgitation (MR) in patients with mitral valve prolapse (MVP) is particularly challenging due to the complex mitral valve anatomy, presence of multiple eccentric jets, and non-holosystolic regurgitation. The continuity equation (CE) offers a potentially more accurate method for assessing MR regurgitant volume in this population. Methods We evaluated patients with MVP and at least moderate MR. Regurgitant volumes (RVol) were quantified using the three-dimensional continuity equation (3D-CE) with direct area measurements and compared with RVol derived from the conventional diameter-based continuity equation (D-CE) and cardiovascular magnetic resonance (CMR). Results Among 72 patients (mean age 59.7 years, 65% female), bileaflet MVP was present in 86% and MAD in 96%. Multiple MR jets (32%) limited PISA accuracy (r=0.40 with CMR). Compared with 3D-CE, D-CE overestimated RVol by 19 mL, though correlation remained strong (r=0.74). In 21 paired studies, 3D-CE and CMR showed excellent agreement (r=0.94, bias +2.1 mL). Severity grading showed strong concordance, with most discrepancies within one category. Conclusions In patients with MVP, incorporating 3D annular measurements into 3D-CE improves agreement with CMR-based volumetric assessment and mitigates overestimation associated with D-CE and PISA-based methods. This approach may be particularly valuable in patients with moderate or moderate-severe MR, in whom conventional echocardiographic parameters are frequently discordant, and supports the role of integrative multimodality imaging in refining MR severity assessment and guiding clinical management. Larger prospective studies are warranted to confirm these findings.
Abdelkader et al. (Tue,) reported a other. Three-dimensional continuity equation improved regurgitant volume assessment accuracy compared to diameter-based continuity equation, reducing overestimation by 19 mL in MVP patients.