Three-dimensional echocardiography showed better correlation with left atrial volume index than 2D imaging (r=0.51 vs r=0.179) and reclassified 45% of patients from moderate to severe MR.
Observational (n=40)
No
Does 3D echocardiography improve the accuracy of mitral regurgitation severity evaluation compared to 2D echocardiography?
3D echocardiography provides a more accurate assessment of mitral regurgitation severity than 2D methods, frequently reclassifying moderate MR to severe.
Effect estimate: r=0.51 for 3D vs r=0.179 for 2D
p-value: p=0.001
Abstract Introduction Evaluating the severity of mitral regurgitation (MR), the recommended parameters are based on flow convergence methods from two-dimensional (2D) imaging, although we know the limitations of this technique. Three-dimensional echocardiography (3DE) could be an alternative method, but all of its benefits are not exactly known yet. We aimed to compare the 2D and 3D methods in the severity evaluation process. Methods In the study, we selected 40 patients randomly (20 male, 72±12 years old, 20 primary and 20 functional MR) who visited the structural outpatient clinic of our department (in the year 2023) regarding their MR, and to evaluate the necessity of intervention. Complex 2D and 3D TTE and TEE exams were performed, and the guideline-recommended parameters were measured to calculate the severity of MR: MR orifice area calculated by 2D flow convergence method (2D EROA), MR orifice area measured by 3D imaging (3D EROA), and the left atrial maximal volume index (LAVi max) as well, which is an important consequential data regarding the severity of MR. Results Based on the guideline, MR was categorized as moderate in 18 cases, whilst in 22 cases it was severe (2D EROA: 0.45±0.27 cm2). Using 3D EROA showed a better correlation with LAVi compared to 2D EROA (r=0.51, p=0.001 vs. r=0.179, p=0.283). Comparing 2D and 3D parameters, we can say that 2D tends to underestimate the real severity of MR (bias=-0.18 cm2, LOA±0.4 cm2). Based on 3D EROA we had to reclassify 18 patients from moderate to severe MR (45%), in 17 cases the classification was correct (43%), and in 5 of the evaluated cases, 2D overestimated the severity (12%). Conclusions The 3DE approach in the evaluation process of MR severity is resulting more accurate classification. In the examined patient group, which consists of both primary and functional etiology of MR 2D-based assessment is underestimating the severity compared to 3D measurements.
Jenei 等（Thu,）对 40 例二尖瓣反流患者进行了观察性研究。评估三维超声心动图与二维超声心动图在有效反流口面积与左心房最大容量指数之间的相关性（3D:r=0.51 vs 2D:r=0.179, p=0.001）。三维超声心动图与左心房容量指数的相关性优于二维成像（r=0.51 vs r=0.179），并将45%的患者从中度 MR 重新分类为重度 MR。