Quantitative Analysis of Mitral Annular Geometry and Function in Healthy Volunteers Using Transthoracic Three-Dimensional Echocardiography
Quantitative Analysis of Mitral Annular Geometry and Function in Healthy Volunteers Using Transthoracic Three-Dimensional Echocardiography
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DOI：
10.1016/j.echo.2014.04.017
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发表时间：
2014-08-01
影响因子：
6.5
通讯作者：
Badano, Luigi P.
中科院分区：
文献类型：
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作者：
Mihaila, Sorina;Muraru, Denisa;Badano, Luigi P.
背景资料：二尖瓣环的定量评估提供了关于二尖瓣返流的病理生理学的信息，并有助于制定修复手术计划。使用当前扫描仪采集的三维（3D）经胸超声心动图数据集具有足够的空间和时间分辨率，可以对二尖瓣环进行定量分析。因此，作者进行了（1）验证研究，以评估在3D经胸超声心动图（TTE）和3D经食管超声心动图（TEE）上进行的二尖瓣环定量分析的一致性，以及（2）规范性研究，以获得二尖瓣环（MA）几何形状和动力学的3D经胸超声心动图参数的参考值。二尖瓣数据集通过3D TEE和3D TTE在30名具有临床指征的TEE的连续患者中获得（验证研究）和224名健康志愿者的3D TTE结果：在验证性研究中，3DTTE和3DTEE获得的MA测量结果相似（P = NS）。在规范性研究中，3DTTE分析MA的可行性（94.5%）和可重复性（组内相关系数= 0.78-0.97）。MA直径、面积和周长与体表面积相关（r > 0.50），但与年龄无关。男性MA面积大于女性（4.9 +/- 1.0 vs 4.5 +/- 0.7 cm（2）/m（2），P=.004）。在收缩期，MA面积减少了29 +/-5%。这种减少主要与前后径缩短（20 +/-7%.Conclusions）有关：与3D TEE相比，3D TTE的MA定量分析在二尖瓣疾病的二尖瓣狭窄患者中是准确的。在健康受试者中，它是高度可行和可重复的。MA几何形状和动力学的参考值的可用性可以促进在临床环境中通过3D TTE实现MA定量分析。
Background: Quantitative assessment of the mitral annulus provides information regarding the pathophysiology of mitral regurgitation and aids in the planning of reparative surgery. Three-dimensional (3D) transthoracic echocardiographic data sets acquired with current scanners have enough spatial and temporal resolution to allow the quantitative analysis of the mitral annulus. Accordingly, the authors performed (1) a validation study to assess the agreement of quantitative analysis of the mitral annulus performed on 3D transthoracic echocardiography (TTE) and 3D transesophageal echocardiography (TEE) and (2) a normative study to obtain the reference values of 3D transthoracic echocardiographic parameters for mitral annular (MA) geometry and dynamics.Methods: Mitral valve data sets were obtained by 3D TEE and 3D TTE in 30 consecutive patients with clinically indicated TEE (validation study) and 3D TTE in 224 healthy volunteers (aged 18-76 years) (normative study).Results: In the validation study, MA measurements obtained by 3D TTE were similar to those obtained by 3D TEE (P = NS). In the normative study, MA analysis by 3D TTE was feasible (94.5%) and reproducible (intraclass correlation coefficient = 0.78-0.97). MA diameters, area, and circumference were correlated with body surface area (r > 0.50 for all) but not with age. Men had larger MA areas than women (4.9 +/- 1.0 vs 4.5 +/- 0.7 cm(2)/m(2), P=.004). During systole, MA area decreased by 29 +/- 5%. This decrease was related mainly to anteroposterior diameter shortening (20 +/- 7%).Conclusions: MA quantitative analysis by 3D TTE was accurate compared with 3D TEE in unselected patients with mitral valve disease. In healthy subjects, it was highly feasible and reproducible. The availability of reference values for MA geometry and dynamics may foster the implementation of MA quantitative analysis by 3D TTE in clinical settings.