Key result
3D echo reconstruction of color Doppler vena contracta correlates strongly with volumetric VSD severity.
Why the study?
To investigate the feasibility and potential value of 3D echocardiographic reconstruction of the color Doppler-imaged vena contracta and flow convergence region for quantitative estimation of ventricular septal defect severity.
Does 3D echocardiographic reconstruction of the color Doppler-imaged vena contracta and flow convergence region accurately quantify the severity of VSD compared to cardiac catheterization in patients with isolated VSD?
Observational (n=19)
Does 3D echocardiographic reconstruction of the color Doppler-imaged vena contracta and flow convergence region accurately quantify the severity of VSD compared to cardiac catheterization in patients with isolated VSD?
Effect estimate: r=0.97
p-value: p=<0.001
3D echocardiographic reconstruction of the color Doppler-imaged vena contracta and flow convergence region provides an accurate quantitative estimation of VSD severity, overcoming the underestimation seen with conventional 2D methods.
3D echo may improve VSD quantification accuracy; leaves open impact on management pending prospective validation.
BACKGROUND: The aim of the present study was to investigate the feasibility and potential value of the computer-controlled, 3D, echocardiographic reconstruction of the color Doppler-imaged vena contracta (CDVC) and the flow convergence (FC) region as a means of accurately and quantitatively estimating the severity of a ventricular septal defect (VSD). METHODS AND RESULTS: We performed a 3D reconstruction of the CDVC and the FC region in 19 patients with an isolated VSD using an ultrasound system interfaced with a Tomtec computer. The variable asymmetric geometry of the CDVC and the FC region could be 3D-visualized in all patients. The 3D-measured areas of CDVC correlated well with volumetric measurements of the severity of VSD (r=0.97, P:<0.001). Regression analysis between the shunt flow rate (calculated from the product of the area of CDVC and the continuous Doppler-derived velocity time integral) and the corresponding reference results (calculated by cardiac catheterization) demonstrated a close correlation (r=0.95, P:<0.001). There was also a good correlation between shunt flow rates calculated using the conventional 2D, 1-axis measurement of the FC isovelocity surface area with the hemispheric assumption (r=0.95, P:<0.001); shunt flow rates calculated using 3D, 3-axis measurements of the FC region (r=0.97, P:<0.01); and reference results by cardiac catheterization. However, the 2D method substantially underestimated the actual shunt flow rate. CONCLUSIONS: The 3D reconstruction of the CDVC and the FC region may aid in quantifying the severity of VSD.
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Ishii et al. (2001) conducted an observational in Isolated ventricular septal defect (n=19). 3D echocardiographic reconstruction of color Doppler-imaged vena contracta and flow convergence region vs. Cardiac catheterization and 2D echocardiography was evaluated on Correlation between 3D-measured areas of color Doppler-imaged vena contracta and volumetric measurements of VSD severity (r=0.97, p=<0.001). 3D echocardiographic reconstruction of the color Doppler-imaged vena contracta correlated strongly with volumetric measurements of ventricular septal defect severity (r=0.97, P<0.001).