Key result
Measurement of mitral valve area by direct planimetry on 3D zoom showed moderate-to-good agreement with 3D quantification (ICC = 0.67) in patients with severe mitral stenosis.
Why the study?
Mitral valve area measurement by 3D echocardiography in mitral stenosis is typically performed via 3D quantification, prompting evaluation of direct planimetry on 3D zoom and comparison between 3D and 2D methods.
Does direct planimetry on 3D zoom agree with 3D quantification and 2D echocardiography for measuring mitral valve area in patients with severe mitral stenosis?
Observational (n=26)
Does direct planimetry on 3D zoom agree with 3D quantification and 2D echocardiography for measuring mitral valve area in patients with severe mitral stenosis?
Effect estimate: ICC 0.67
Direct planimetry on 3D zoom shows moderate-to-good agreement with 3D quantification for measuring mitral valve area in severe mitral stenosis, offering a simple alternative for clinical practice.
Direct 3D zoom planimetry may simplify MVA assessment in severe MS; leaves open prospective outcome validation before wider adoption.
BACKGROUND: Measurement of the mitral valve area (MVA) in patients with mitral stenosis (MS) by 3D echocardiography (3DE) is usually done via 3D quantification (3DQ). The present study on patients with severe MS sought to evaluate the agreement regarding the MVA measurement between 3DQ and direct planimetry on 3D zoom and also between 3DE and 2DE. METHODS: Twenty-six patients (22 female, mean age:34.5 ± 14.0 years) with severe MS diagnosed by 2D transthoracic echocardiography(2DTTE) underwent 3D transesophageal echocardiography (3DTEE). Direct planimetry, the pressure half-time (PTH), and the continuity equation(CE) constituted 3 conventional 2DTTE methods, and 3DQ and direct planimetry on 3D zoom comprised two 3DTEE methods applied for the MVA measurement. Agreement between the 2D and 3D methods was assessed using the Bland-Altman plot and measuring the intra-class correlation coefficient (ICC). RESULTS: , respectively; P = 0.026). The agreement between 3DQ and 3D zoom for the MVA measurement was moderate to good by the Bland-Altman plot (ICC = 0.67). The mean MVA measured by 2DE (all 3 methods of direct planimetry, the PTH, and the CE) was significantly larger than that derived by 3DE (both methods of 3DQ and direct planimetry on 3D zoom) (all Ps < 0.05). A moderate agreement between 3DQ and 2D planimetry (ICC = 0.43) was found by the Bland-Altman plot. CONCLUSIONS: The MVA measurement by direct planimetry on 3D zoom showed a moderate-to-good agreement with 3DQ; it may, thus, be used in clinical practice as a simple method for the measurement of the MVA in patients with MS.
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Sadeghian et al. (2019) conducted an observational in Severe mitral stenosis (n=26). Direct planimetry on 3D zoom vs. 3D quantification (3DQ) and 2D echocardiography was evaluated on Agreement regarding the mitral valve area (MVA) measurement between 3DQ and direct planimetry on 3D zoom (ICC 0.67). Measurement of mitral valve area by direct planimetry on 3D zoom showed moderate-to-good agreement with 3D quantification (ICC = 0.67) in patients with severe mitral stenosis.
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