Key result
The single beat method RRp/RRpp = 1 for measuring mitral valve area by pressure half time showed no significant difference compared to the standard multiple-beat approach (0.8 vs 0.9 cm2, P=0.472).
Why the study?
Determining mitral stenosis severity in AF by averaging multiple cycles is time-consuming, and whether a single beat method can measure MVA and transmitral gradient remains uncertain.
Does the single beat method (RRp/RRpp = 1) accurately measure mitral valve area and transmitral gradient compared to the standard multiple-beat approach in patients with mitral stenosis and atrial fibrillation?
Cross-Sectional (n=48)
Does the single beat method (RRp/RRpp = 1) accurately measure mitral valve area and transmitral gradient compared to the standard multiple-beat approach in patients with mitral stenosis and atrial fibrillation?
The single beat method (RRp/RRpp = 1) for measuring mitral valve area by pressure half time is a feasible alternative to the standard multiple-beat averaging approach in patients with mitral stenosis and atrial fibrillation.
Single-beat pressure half-time yields comparable mitral valve areas; hypothesis-generating and should not yet change practice.
Purpose : In mitral stenosis (MS) patients, determining stenosis severity in atrial fibrillation (AF) is time-consuming by averaging measurement by multiple cardiac cycles. Whether a single beat method can be used to measure the mitral valve area (MVA) and transmitral gradient for stenosis severity assessment in AF is still uncertain. Methods : Forty-eight MS patients with AF (mean age 46.8+8.6 years) underwent routine echocardiographic study. The MVA by pressure half time (PHT) and transmitral mean gradient were measured by four methods: the standard approach (averaging multiple beats), single short R-R cycle, single long R-R cycle, and single beat RRp/RRpp = 1. 2D and 3D planimetry MVA were measured at the mitral orifice. Results : The single beat RRp/RRpp = 1 showed no significant difference in MVA PHT measurement compared with standard approach (0.8 (0.3 – 2.7 vs 0.9 + 0.3 cm 2 ) cm 2 , P = 0.472), whereas there was a significant difference in MVA by PHT when short R-R cycle (1.0 (0.4 – 2.7) cm 2 , P = 0.0001) and long R-R cycle (0.8 (0.3 – 1.7) cm 2 , P = 0.013) were selected. There was a significant difference in mean MVG measurement when short R-R cycle (12.1 + 3.9 mmHg, P = 0.001) , long R-R cycle (10.1 + 4.0 mmHg, P = 0.007), and single beat RRp/RRpp = 1 (12.2 + 4.4 mmHg, P = 0.0001) were selected. Correlation coefficients for MVA PHT calculated by single beat RRp/RRpp = 1 compared with MVA PHT measured by standard approach are r = 0.87 ( P < 0.001). There is weak correlation in measurement MVA between PHT single beat RRp/RRpp = 1 and 3D planimetry ( r = 0.316, P = 0.044). Conclusion : In AF, the single beat method RRp/RRpp = 1 for measurement MVA by PHT in MS has a high correlation with the current standard approach by averaging multiple beats. Compared with MVA by 3D planimetry as the reference measurement of MVA, measurement of MVA by PHT standard approach and single beat RRp/RRpp = 1 have a weak correlation in AF patients. MVA by planimetry especially 3D planimetry, is considered as a reference measurement, but MVA by PHT single beat RRp/RRpp =1 can be an alternative, especially when MVA by planimetry is not feasible.
No takes yet. Share an insight, caveat, or question.
Ardini et al. (2022) conducted a cross-sectional in Mitral stenosis with atrial fibrillation (n=48). Single beat method RRp/RRpp = 1 vs. Standard approach (averaging multiple beats) was evaluated on Mitral valve area (MVA) by pressure half time (PHT) (p=0.472). The single beat method RRp/RRpp = 1 for measuring mitral valve area by pressure half time showed no significant difference compared to the standard multiple-beat approach (0.8 vs 0.9 cm2, P=0.472).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: