Real-time three-dimensional echocardiography improves the accuracy of mitral regurgitation severity assessment by overcoming the limitations of 2D methods in evaluating asymmetric vena contracta and proximal isovelocity surface areas.
Does real-time three-dimensional echocardiography improve the accuracy of assessing mitral regurgitation severity compared to conventional 2D methods in patients with mitral regurgitation?
Real-time 3D echocardiography provides superior accuracy over 2D methods for quantifying mitral regurgitation severity by directly measuring the asymmetric vena contracta and proximal isovelocity surface areas.
Mitral regurgitation (MR) is considered the most common valve disease with a prevalence of 2-3 % of significant regurgitation (moderate to severe and severe) in the general population. Accurate assessment of the severity of regurgitation was demonstrated to be of significant importance for patient management and prognosis and consequently has been widely recognized in recent guidelines. However, evaluation of severity of valvular regurgitation can be potentially difficult with the largest challenges presenting in cases of mitral regurgitation. Real-time three-dimensional echocardiography (RT3DE) by the use of color Doppler has the potential to overcome the limitations of conventional flow quantification using 2D color Doppler methods. Recent studies validated the application of color Doppler RT3DE for the assessment of flow based on vena contracta area (VCA) and proximal isovelocity surface area (PISA). Particularly, the assessment of VCA by color Doppler RT3DE led to a change of paradigm by understanding the VCA as being strongly asymmetric in the majority of patients and etiologies. In this review, we provide a discussion of the current state of clinical evaluation, limitations, and future perspectives of the two methods and their presentation in recent literature and guidelines.
Buck et al. (Mon,) conducted a review in Mitral Regurgitation. Real-time three-dimensional echocardiography (RT3DE) vs. 2D echocardiography was evaluated. Real-time three-dimensional echocardiography improves the accuracy of mitral regurgitation severity assessment by overcoming the limitations of 2D methods in evaluating asymmetric vena contracta and proximal isovelocity surface areas.