Key result
Three-dimensional transthoracic echocardiography for mitral annulus evaluation demonstrated 91% feasibility compared to 96% for transesophageal echocardiography, with strong correlation (r>0.80).
Why the study?
Although 3D-TOE has been the only reliable echocardiographic method for mitral annulus evaluation, newer TTE probes may provide accurate measurements when TOE is contraindicated.
Does 3D-TTE provide feasible and accurate mitral annulus measurements compared to 3D-TOE in patients with normal and abnormal mitral valves?
Observational (n=121)
Does 3D-TTE provide feasible and accurate mitral annulus measurements compared to 3D-TOE in patients with normal and abnormal mitral valves?
3D-TTE with dedicated MVQ software is a feasible and accurate alternative to 3D-TOE for evaluating the mitral annulus.
Supports 3D-TTE as a feasible mitral annulus alternative; leaves open prospective validation before clinical adoption.
Introduction: Mitral annulus (MA) assessment is of utmost importance for the management of patients with mitral valve (MV) abnormalities and Three-dimensional transesophageal echocardiography (3D-TOE) has been the only reliable echocardiographic method for the evaluation of the mitral annulus by now. However, newer transthoracic echocardiography (TTE) probes have enabled to provide accurate measurements when TOE is contraindicated. The aim of this study is to assess the feasibility of 3D-TTE analysis of MA and the level of agreement with 3D-TOE measurements. Methods: A total of 121 consecutive patients were assessed with 3D-TTE and TOE. All MA parameters were retrospectively analyzed with the dedicated 4D-autoMVQ application. Bland-Altman analysis and intraclass correlation coefficient were used for the comparison and agreement between the two methods. Half of our patients had normal mitral valves and served as control group, while the other half had various mitral valve pathologies. Results: AutoMVQ analysis was not feasible in 11 out of 121 TTE examinations (91% feasibility) and in 4 out of 121 TOE examinations (96% feasibility). MA area and perimeter were slightly larger in TTE than those measured by TOE (12.7±3.6 vs 12.4±3.2cm2 for area and 12.7±1.7 vs 12.5±1.6cm for perimeter), however still showing strong correlation (r=0.942 and r=0.922 respectively). The majority of MV measurements were similar between the two methods with strong correlation (r>0.80). Conclusions: Assessment of the MV with 3D TTE with dedicated MVQ software is feasible and accurate, showing strong correlation and agreement with TOE measurements.
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Παπαδόπουλος et al. (2022) conducted an observational in Mitral valve abnormalities (n=121). Three-dimensional transthoracic echocardiography (3D-TTE) vs. Three-dimensional transesophageal echocardiography (3D-TOE) was evaluated on Feasibility of AutoMVQ analysis. Three-dimensional transthoracic echocardiography for mitral annulus evaluation demonstrated 91% feasibility compared to 96% for transesophageal echocardiography, with strong correlation (r>0.80).
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