Mitral valve area assessment using the PISA method correlated closely with planimetry (r=0.96, P<0.0001) and, unlike the PHT method, was not affected by extreme net atrioventricular compliance.
Observational (n=51)
Yes
Does the PISA method provide a more accurate calculation of mitral valve area than the PHT method in patients with mitral stenosis, particularly those with extreme net atrioventricular compliance?
The PISA method is recommended over the PHT method for calculating mitral valve area in patients with mitral stenosis and extreme net atrioventricular compliance, as it is not affected by changes in compliance.
Effect estimate: r = 0.96 (PISA); r = 0.69 (PHT)
p-value: p=< 0.0001
AIMS: The aim of this study was to test the hypothesis that, unlike calculation of the mitral valve area (MVA) with the pressure half-time method (PHT), the proximal isovelocity surface area method (PISA) is not affected by changes in net atrioventricular compliance (C(n)). METHODS AND RESULTS: We studied 51 patients with mitral stenosis (MS) from two centres. MVA was assessed with the PISA (MVA(PISA)), PHT (MVA(PHT)), and planimetry (MVA(PLN), serving as the gold standard) method. C(n) was calculated with a previously validated equation using 2D echocardiography. MVA(PISA) closely correlated with MVA(PLN) (r = 0.96, P < 0.0001), while MVA(PHT) and MVA(PLN) showed a weaker but still good correlation (r = 0.69, P < 0.0001). The correlation between MVA(PHT) and MVA(PLN) for patients with C(n) between 4 and 6 mL/mmHg (considered to be normal) was excellent (r = 0.93, P < 0.0001), but that for patients with C(n) of less than 4 or more than 6 mL/mmHg was not as good (r = 0.64, P < 0.0001). Importantly, a significant inverse correlation was detected between the percentage difference among MVA(PHT), MVA(PLN), and C(n) (r = -0.77, P < 0.0001), but the line of fit was nearly flat for the percentage difference among MVA(PISA), MVA(PLN), and C(n) (r = 0.1, P = 0.388). CONCLUSION: MVA calculated with both the PISA and PHT methods correlated well with MVA calculated with the planimetry method. However, the PISA rather than PHT is recommended for patients with MS and extreme C(n) values because PISA, unlike PHT, is not affected by changes in C(n).
Omar et al. (Tue,) conducted a observational in Mitral stenosis (n=51). Proximal isovelocity surface area method (PISA) vs. Pressure half-time method (PHT) and planimetry was evaluated on Correlation of mitral valve area (MVA) calculated by PISA and PHT with planimetry (r = 0.96 (PISA); r = 0.69 (PHT), p=< 0.0001). Mitral valve area assessment using the PISA method correlated closely with planimetry (r=0.96, P<0.0001) and, unlike the PHT method, was not affected by extreme net atrioventricular compliance.