Key result
Real-time transesophageal three-dimensional (RT3D-TEE) scoring showed a strong correlation with the 2D Wilkins system for assessing mitral valve area (r = 0.846, p < 0.001).
Why the study?
Existing 2D and 3D mitral valve scoring systems have limitations, requiring evaluation of their overlap and accuracy to determine the correlation between the 2D Wilkins and RT3D-TEE systems.
Does the RT3D-TEE scoring system correlate with the 2D Wilkins scoring system for morphological assessment of the mitral valve in patients with moderate to severe mitral stenosis?
Cross-Sectional (n=156)
Does the RT3D-TEE scoring system correlate with the 2D Wilkins scoring system for morphological assessment of the mitral valve in patients with moderate to severe mitral stenosis?
Effect estimate: r = 0.846
p-value: p=<0.001
There is a high correlation between 2D Wilkins and RT3D-TEE scoring systems for evaluating dominant morphological features of the mitral valve, though 2D echocardiography may overestimate valve area and miss commissural involvement.
Supports RT3D-TEE as adjunct to 2D Wilkins in mitral stenosis; leaves open whether it alters management or outcomes.
BACKGROUND: To quantify valvular morphological assessment, some two-dimensional (2D) and three-dimensional (3D) scoring systems have been developed to target the patients for balloon mitral valvuloplasty; however, each scoring system has some potential limitations. To achieve the best scoring system with the most features and the least restrictions, it is necessary to check the degree of overlap of these systems. Also the factors related to the accuracy of these systems should be studied. We aimed to determine the correlation between the 2D Wilkins and real-time transesophageal three-dimensional (RT3D-TEE) scoring systems. METHODS: This cross-sectional study was performed on 156 patients with moderate to severe mitral stenosis who were candidates for percutaneous balloon valvuloplasty. To morphologic assessment of mitral valve, patients were examined by 2D-transthoracic echocardiography and RT3D-TEE techniques on the same day. RESULTS: (p = 0.001). We found a strong correlation between the values of mitral valve area assessed by 2D and 3D techniques (r = 0.846, p < 0.001). CONCLUSION: There is a high correlation between the two scoring systems in terms of evaluating dominant morphological features. Partially, mitral valve area overestimation in the 2D-transthoracic echocardiography and its inability to assess commissural involvement as well as its dependence on patient age were exceptions in this study.
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Toufan et al. (2021) conducted a cross-sectional in Moderate to severe mitral stenosis (n=156). Real-time transesophageal three-dimensional (RT3D-TEE) scoring system vs. 2D Wilkins scoring system was evaluated on Correlation between the values of mitral valve area assessed by 2D and 3D techniques (r = 0.846, p=<0.001). Real-time transesophageal three-dimensional (RT3D-TEE) scoring showed a strong correlation with the 2D Wilkins system for assessing mitral valve area (r = 0.846, p < 0.001).
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