Quantitative three-dimensional echocardiographic analysis of the bicuspid aortic valve and aortic root: A single modality approach.
Quantitative three-dimensional echocardiographic analysis of the bicuspid aortic valve and aortic root: A single modality approach.
复制标题
二尖瓣主动脉瓣和主动脉根部的定量三维超声心动图分析：单一模式方法。
DOI：
10.1111/jocs.14387
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发表时间：
2020
影响因子：
1.6
通讯作者：
Gorman,RobertC
中科院分区：
文献类型：
--
作者：
Levack,MelissaM;Mecozzi,Gianclaudio;Jainandunsing,JayantS;Bouma,Wobbe;Jassar,ArminderS;Pouch,AlisonM;Yushkevich,PaulA;Mariani,MassimoA;Jackson,BenjaminM;Gorman3rd,JosephH;Gorman,RobertC
背景二叶式主动脉瓣（BAV）患者的根部重塑和瓣膜功能障碍的模式各不相同。二维超声心动图是主动脉瓣功能障碍患者的标准监测方式。然而，通常需要辅助计算机断层扫描或磁共振成像来表征主动脉根部病理学的相关模式。相反，三维（3D）超声心动图与新颖的定量建模技术的配对允许对整个根复合体进行单一模态描述。我们试图用这种定量方法确定 3D 主动脉瓣和根部几何形状。方法对 5 名三尖瓣主动脉瓣 (TAV) 患者和 5 名 BAV 患者进行经食管实时 3D 超声心动图检查。没有患者有瓣膜功能障碍或主动脉根部病变的证据。使用定制的图像分析协议来评估 3D 主动脉环、瓣膜和根部几何形状。结果两组的环、窦和窦管连接处直径和面积相似。 TAV 组的接合长度和面积（分别为 7.25±±0.98mm 和 298±±118 mm2）高于 BAV 组（5.67±±1.33mm 和 177±±43 mm2；P= .07且P= .01)。尖瓣表面积与瓣环面积、接合高度以及瓣下和瓣上隆起指数在各组之间没有显着差异。结论基于单模态 3D 超声心动图的建模可以定量描述主动脉瓣和根部的几何形状。这项技术与新的指标一起将提高我们对 BAV 群体正常和病理几何形状的理解，并可能有助于识别不良重塑的几何预测因素并指导定制的手术治疗。
BackgroundPatients with bicuspid aortic valves (BAV) are heterogeneous with regard to patterns of root remodeling and valvular dysfunction. Two‐dimensional echocardiography is the standard surveillance modality for patients with aortic valve dysfunction. However, ancillary computed tomography or magnetic resonance imaging is often necessary to characterize associated patterns of aortic root pathology. Conversely, the pairing of three‐dimensional (3D) echocardiography with novel quantitative modeling techniques allows for a single modality description of the entire root complex. We sought to determine 3D aortic valve and root geometry with this quantitative approach.MethodsTransesophageal real‐time 3D echocardiography was performed in five patients with tricuspid aortic valves (TAV) and in five patients with BAV. No patient had evidence of valvular dysfunction or aortic root pathology. A customized image analysis protocol was used to assess 3D aortic annular, valvular, and root geometry.ResultsAnnular, sinus and sinotubular junction diameters and areas were similar in both groups. Coaptation length and area were higher in the TAV group (7.25 ± 0.98 mm and 298 ± 118 mm2, respectively) compared to the BAV group (5.67 ± 1.33 mm and 177 ± 43 mm2;P= .07 andP= .01). Cusp surface area to annular area, coaptation height, and the sub‐ and supravalvular tenting indices did not differ significantly between groups.ConclusionsSingle modality 3D echocardiography‐based modeling allows for a quantitative description of the aortic valve and root geometry. This technique together with novel indices will improve our understanding of normal and pathologic geometry in the BAV population and may help to identify geometric predictors of adverse remodeling and guide tailored surgical therapy.