ECG-gated 64-MDCT evaluation of mechanical heart valves showed strong correlation with cinefluoroscopy for measuring opening angle (r = 0.77, p < 0.001) and high interobserver agreement.
Observational (n=62)
Does ECG-gated 64-MDCT accurately evaluate mechanical heart valve size and function compared to cinefluoroscopy and manufacturer specifications in patients with mechanical valves?
ECG-gated 64-MDCT is a promising and accurate modality for assessing the size and function of mechanical heart valves, showing strong correlation with cinefluoroscopy.
Effect estimate: r = 0.77
p-value: p=<0.001
OBJECTIVE: The purpose of our study was to determine whether CT can accurately evaluate mechanical heart valve size and function. MATERIALS AND METHODS: Sixty-two patients with mechanical valves (37 single-disc, 27 bileaflet; 59 aortic, 5 mitral) were evaluated with ECG-gated 64-MDCT and transthoracic echocardiography; a subset of 10 patients underwent cinefluoroscopy. Two readers independently interpreted each study. RESULTS: The mean age of the patients was 46.4 +/- 14.4 years; 50 were men and 12 were women. There was excellent correlation, and differences between CT readers were absent to small in measuring the opening angle (r = 0.96, p < 0.001; 76.7 +/- 9.0 degrees vs 76.8 +/- 9.6 degrees , p = 0.73), annulus diameter (r = 0.96, p < 0.001; 25.9 +/- 3.3 vs 25.9 +/- 3.2 mm, p = 0.62), and geometric orifice area (r = 0.98, p < 0.001; 3.8 +/- 0.9 vs 3.6 +/- 0.8 cm(2), p < 0.001). There was strong correlation without difference in opening angle between CT and cinefluoroscopy (r = 0.77, p < 0.001; 79.2 degrees +/- 9.8 degrees vs 77.2 degrees +/- 15.5 degrees , p = 0.45). Compared with manufacturer specifications, CT reported opening angles that were smaller for single-disc valves (n = 36, 67.4 degrees +/- 5.7 degrees vs 75 degrees , p < 0.001) and similar for bileaflet valves (n = 42 for 21 valves, 83.8 degrees +/- 3.9 degrees vs 85 degrees , p = 0.05), valves, with small underestimation with CT versus specifications in annulus diameter (n = 41; r = 0.75, p < 0.001; 26.4 +/- 3.0 vs 27.5 +/- 3.3 mm, p = 0.003), and geometric orifice area (n = 35; r = 0.90, p < 0.001; 3.7 +/- 0.7 vs 3.8 +/- 0.8 cm(2), p = 0.04). Each disc closed fully on CT; none had more than mild regurgitation on echocardiography. CONCLUSION: CT can measure the size and function of mechanical valves with high interobserver agreement and results similar to specifications. The opening angle with CT strongly correlates with cinefluoroscopy. CT is promising for the assessment of mechanical valves.
LaBounty et al. (Tue,) conducted a observational in Mechanical heart valves (n=62). ECG-gated 64-MDCT vs. Cinefluoroscopy, transthoracic echocardiography, and manufacturer specifications was evaluated on Correlation of opening angle between CT and cinefluoroscopy (r = 0.77, p=<0.001). ECG-gated 64-MDCT evaluation of mechanical heart valves showed strong correlation with cinefluoroscopy for measuring opening angle (r = 0.77, p < 0.001) and high interobserver agreement.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: