Key result
3D planimetry yields ~0.13 cm2 smaller MVA vs 2D, aligning strongly with pressure half-time.
Why the study?
The study was conducted to compare transthoracic 3D planimetry to 2D planimetry for calculating mitral valve area and to assess correlation with echocardiographic severity parameters in rheumatic mitral stenosis.
Does transthoracic 3D planimetry improve the accuracy of mitral valve area calculation compared to 2D planimetry in patients with rheumatic mitral stenosis?
Cross-Sectional (n=51)
Blinded observers
No
Does transthoracic 3D planimetry improve the accuracy of mitral valve area calculation compared to 2D planimetry in patients with rheumatic mitral stenosis?
Transthoracic 3D planimetry provides mitral valve area measurements that are more consistent with pressure half-time calculations and correlate well with hemodynamic severity in rheumatic mitral stenosis compared to 2D echocardiography.
Answers are grounded in this paper and cite their sources.
May support 3D over 2D planimetry for mitral valve area in rheumatic stenosis; hypothesis-generating and requires prospective outcome validation.
Objectives: The objective of the study was to compare transthoracic 3D planimetry to 2D planimetry in calculating mitral valve area along with correlation of various echocardiographic parameters of severity of mitral stenosis among these modalities. Methodology: Patients with (RMS) were enrolled. Keeping 2D PHT as reference mitral valve area (MVA) was calculated and it was compared to the results derived by transthoracic 2D and 3D planimetry. Agreement between the 2D and 3D methods was assessed by measuring the intraclass correlation coefficient (ICC). Results: 51 patients were included. 36 (70.6%) were females; mean age was 33 ± 6 years. Mean gradient was 14.5 ± 3.9 mmhg while mean Pulmonary artery systolic pressure (PASP) was 31.6 ± 6 mmhg. MVA’s derived by PHT, 3D planimetry, and 2D were 1.04 ± 0.24, 1.07 ± 0.24, 1.21 ± 0.27 cm2 respectively. 3D obtained areas were significantly lower compared to 2D (p< 0.001) and insignificantly greater from PHT (p = 0.18). 3D demonstrated best agreement with MVA PHT (95% limits of agreement: 0.67 to 0.92; ICC 0.84). MVA 3D planimetry and MVA 2D correlated well with PASP and mean pressure gradient but showed weak correlation with left atrium size. Conclusion: 3D planimetry derived mitral area compared to 2D echocardiography are more in line with PHT calculated area and correlates well to hemodynamic parameters of severity.
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Ali et al. (2022) conducted a cross-sectional in Rheumatic Mitral Stenosis (n=51). 3D transthoracic planimetry vs. 2D planimetry was evaluated on Mitral valve area (MVA) (MD -0.13, p=<0.001). 3D transthoracic planimetry yielded significantly lower mitral valve areas compared to 2D planimetry (mean difference -0.13 cm2, p<0.001) and showed strong agreement with the pressure half-time method.
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