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January 31, 2020Cardiovascular Ultrasound3 citationsOpen Access

The impact of different geometric assumption of mitral annulus on the assessment of mitral regurgitation volume by Doppler method

WWWugang WangZWZhibin WangJLJunfang Li

Key Result

Evaluating mitral regurgitation volume using an ellipse geometric assumption of the mitral annulus showed no significant difference compared to RT3DE (mean difference 1.7 ml, P=0.0844).

Study Design

Type

Observational (n=88)

Structured PICO

Does an ellipse geometric assumption of the mitral annulus improve the accuracy of mitral regurgitation volume assessment by quantitative pulsed Doppler compared to a circular assumption?

P
Population
88 patients with varying degrees of mitral regurgitation (MR)
I
Intervention
Quantitative pulsed Doppler (QPD) method using ellipse geometric assumption of mitral annulus (QPD-MA A4C + A2C)
C
Comparator
Quantitative pulsed Doppler (QPD) method using circular geometric assumption of mitral annulus, and real time three-dimensional echocardiography (RT3DE) as reference
O
Outcome
Mitral regurgitation volume (MRvol)surrogate

Using an ellipse geometric assumption rather than a circular one for the mitral annulus improves the accuracy of mitral regurgitation volume assessment by quantitative pulsed Doppler.

Main Result

Effect estimate: Mean difference 1.7 ml

p-value: p=0.0844

Abstract

Abstract Background Mitral regurgitation volume (MRvol) by quantitative pulsed Doppler (QPD) method previously recommended suffers from geometric assumption error because of circular geometric assumption of mitral annulus (MA). Therefore, the aim of this study was to evaluate the impact of different geometric assumption of MA on the assessment of MRvol by two-dimensional transthoracic echocardiographic QPD method. Methods This study included 88 patients with varying degrees of mitral regurgitation (MR). The MRvol was evaluated by QPD method using circular or ellipse geometric assumption of MA. MRvol derived from effective regurgitant orifice area by real time three-dimensional echocardiography (RT3DE) multiplied by MR velocity-time integral was used as reference method. Results Assumption of a circular geometry of MA, QPD-MA A4C and QPD-MA PLAX overestimated the MRvol by a mean difference of 10.4 ml ( P < 0.0001) and 22.5 ml ( P < 0.0001) compared with RT3DE. Assumption of an ellipse geometry of MA, there was no significant difference of MRvol (mean difference = 1.7 ml, P = 0.0844) between the QPD-MA A4C + A2C and the RT3DE. Conclusions Assuming that the MA was circular geometry previously recommended, the MRvol by QPD-MA A4C was overestimated compared with the reference method. However, assuming that the MA was ellipse geometry, the MRvol by the QPD-MA A4C + A2C has no significant difference with the reference method.

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Cite This Study

Wang et al. (2020) conducted an observational in Mitral regurgitation (n=88). Quantitative pulsed Doppler using ellipse geometric assumption of mitral annulus vs. Quantitative pulsed Doppler using circular geometric assumption and RT3DE reference was evaluated on Mitral regurgitation volume (MRvol) compared to RT3DE reference method (Mean difference 1.7 ml, p=0.0844). Evaluating mitral regurgitation volume using an ellipse geometric assumption of the mitral annulus showed no significant difference compared to RT3DE (mean difference 1.7 ml, P=0.0844).

synapsesocial.com/papers/6a13da21a4182367b162557dhttps://doi.org/10.1186/s12947-020-0187-6
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