Key result
Real-time 2D echo accurately matches direct operative mitral valve area in ~86% of patients.
Why the study?
Catheterization cannot accurately assess mitral valve orifice area when mitral regurgitation is present because total diastolic flow is frequently unknown.
Does real-time, two-dimensional echocardiography accurately measure mitral valve orifice area compared to direct measurement at operation in patients with mitral valve disease?
Observational (n=20)
Does real-time, two-dimensional echocardiography accurately measure mitral valve orifice area compared to direct measurement at operation in patients with mitral valve disease?
Real-time two-dimensional echocardiography provides an accurate, noninvasive method for measuring mitral valve orifice area, even in the presence of mitral regurgitation.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Twenty-five years ago, Henry et al. reported on the ability of the then-new field of two-dimensional echocardiography to planimeter the mitral valve orifice. The following years led to the development of Doppler echocardiography, which provided hemodynamic information about rheumatic heart disease”
Supports 2D echo for mitral orifice assessment; leaves open whether it alters decisions in valve disease.
A quantitative assessment of mitral valve orifice area can be achieved in patients with pure mitral stenosis by cardiac catheterization. In the presence of mitral regurgitation, however, accurate measurement often is impossible because total diastolic flow through the mitral valve frequently is unknow. Using a recently developed real-time, two-dimensional echocardiography system, we are able to obtain cross-sectional images of the mitral valve by scanning the heart perpendicular to its long axis at the level of the tip of the mitral leaflets. Twenty consecutive patients undergoing operation for mitral valve disease were studied during the week prior to operation. In 18 of 20 (90%) the mitral orifice was imaged successfully in early diastole by two-dimensional echocardiography so that mitral valve orifice area could be measured directly in square centimeters. In 14 patients (ten with associated mitral regurgitation), mitral orifice area was measured both by echocardiography and directly at time of operation. In 12 of 14 (86%) patients, mitral orifice area by two-dimensional echocardiography was within 0.3 square centimeters of that measured at operation (correlation coefficient for all 14 patients equals 0.92). We conclude that two-dimensional echocardiography is extremely useful in the evaluation of patients with mitral valve disease because it provides a noninvasive method for directly measuring the mitral valve orifice area that is accurate even in the presence of mitral regurgitation.
No takes yet. Share an insight, caveat, or question.
Henry et al. (1975) conducted an observational in Mitral valve disease (n=20). Real-time, two-dimensional echocardiography vs. Direct measurement at time of operation was evaluated on Agreement of mitral orifice area measurement with direct measurement at operation (correlation coefficient 0.92). Real-time, two-dimensional echocardiography measured mitral valve orifice area within 0.3 square centimeters of direct operative measurement in 86% of patients (correlation coefficient 0.92).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: