Key result
CCTA yields ~95% diagnostic accuracy for mitral valve prolapse based on motion amplitude versus TTE.
Why the study?
Multi-detector cardiac CT is widely applied to detect heart valve morphology and function, motivating a comparison between coronary CT angiography and trans-thoracic echocardiography in patients with mitral valve prolapse.
Does coronary CT angiography improve diagnostic accuracy compared to trans-thoracic echocardiography in patients with mitral valve prolapse?
Observational (n=90)
Single-blind
No
Does coronary CT angiography improve diagnostic accuracy compared to trans-thoracic echocardiography in patients with mitral valve prolapse?
p-value: p=<0.001
Coronary CT angiography provides higher accuracy and reliability than trans-thoracic echocardiography for assessing mitral valve prolapse.
Supports coronary CT angiography evaluation for mitral valve prolapse; leaves open clinical utility versus trans-thoracic echocardiography.
OBJECTIVE: At present, multi-detector cardiac CT has been widely applied in the detection of heart valve morphology and function. This study aims to compare the coronary CT angiography and trans-thoracic echocardiography for patients with mitral valve prolapse. METHODS: CT angiography and trans-thoracic echocardiography were adopted to detect the movement range and thickness of valvula bicuspidalis. The ultrasonic parameters of CT angiography were considered as standard reference value. RESULTS: Receiver operating characteristic (ROC) curve showed that the area of mitral valve motion amplitude under ROC curve was 95% detected by CT angiography with statistical significance (P < 0.001). Based on the intercept point on the ROC curve, the sensitivity and accuracy of mitral valve amplitude detected by CT angiography was 69.2 and 95.6%, the false positive and false negative rate was 5.2 and 32.4%, the predicted value of positive and negative was 92.9 and 76.9% and the consistency rate of motion range and leaf thickness detected by CT angiography was 83.3 and 47.5%. Trans-thoracic echocardiography showed that the thickness and motion range of mitral leaflet was (1.95 ± 0.22) mm and (1.5 ± 2.28) mm. The thickness and motion range of mitral leaflet that detected by CT was (2.00 ± 0.54) mm and (3.76 ± 2.1) mm. CONCLUSION: The accuracy and reliability of CT angiography for patients with mitral valve prolapse are higher than those of trans-thoracic echocardiography.
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Li et al. (2019) conducted an observational in Mitral valve prolapse (n=90). Coronary CT angiography vs. Trans-thoracic echocardiography was evaluated on Area under the ROC curve for mitral valve motion amplitude (95% CI 0.88-1.0, p=<0.001). Coronary CT angiography demonstrated high diagnostic accuracy for mitral valve prolapse based on motion amplitude, with an area under the ROC curve of 95% compared to trans-thoracic echocardiography.
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