Study of Degenerative Mitral Regurgitation Using Three-Dimensional Echocardiography and EchoPAC GE Health Care Software 4D Auto MVQ: Comparison Between Transthoracic and Transesophageal Examination

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2024-11-27 DOI:10.1111/echo.70040

Ginevra Fioretti, Alice Tolomei, Piera Ciaramella, Antonio Lio, Ernesto Cristiano, Giulio Cacioli, Federica Tempestini, Federico Ranocchi, Viviana Maestrini, Amedeo Pergolini

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引用次数: 0

Abstract

Background

Preoperative echocardiographic assessment is critical for patients with severe degenerative mitral regurgitation to ensure personalized surgical mitral valve repair. This study aimed to compare the diagnostic accuracy of three-dimensional transthoracic echocardiography (3D TTE) and three-dimensional transesophageal echocardiography (3D TEE) in identifying valvular lesions, using surgical findings as the reference. Additionally, we evaluated whether annular dimensional parameters derived from TTE and TEE, using dedicated 3D software, could confirm whether 3D TTE alone offers a comprehensive preoperative evaluation.

Methods

We enrolled 60 patients with severe organic mitral regurgitation scheduled for surgical valve repair. Each patient underwent preoperative 3D TTE, intraoperative 3D TEE prior to surgery, followed by annuloplasty. Mitral valve reconstructions from both TTE and TEE were compared, and dedicated 3D software (EchoPAC GE-Health-Care Software 3D-auto-MVQ) was employed to reconstruct annular geometries from both methods.

Results

Both 3D TTE and 3D TEE demonstrated comparable accuracy in identifying diseased scallops (overall accuracy: 3D TTE 91.8%, 3D TEE 98.1%, p > 0.05). However, 3D TTE was inferior to 3D TEE in identifying multiple chordal ruptures (accuracy: 3D TTE 80%, 3D TEE 100%). Quantitative analysis of the mitral annulus revealed that 3D TTE and 3D TEE yielded overlapping results for static parameters (p > 0.05), whereas dynamic parameters differed significantly (p < 0.05).

Conclusions

In the selected population, 3D TTE demonstrated diagnostic accuracy comparable to transesophageal echocardiography in identifying mitral valve lesions. Furthermore, with the use of dedicated 3D software, TTE alone may provide a comprehensive and noninvasive preoperative evaluation, particularly for static annular parameters. Further studies are warranted to corroborate these findings.

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使用三维超声心动图和 EchoPAC GE Health Care 软件 4D Auto MVQ 研究退行性二尖瓣反流：经胸和经食道检查的比较。

背景：术前超声心动图评估对严重退行性二尖瓣反流患者至关重要，可确保二尖瓣修复手术的个性化。本研究旨在以手术结果为参考，比较三维经胸超声心动图（3D TTE）和三维经食道超声心动图（3D TEE）在识别瓣膜病变方面的诊断准确性。此外，我们还评估了使用专用三维软件从 TTE 和 TEE 中得出的瓣环尺寸参数是否能证实仅靠三维 TTE 是否能提供全面的术前评估：我们招募了 60 名计划进行手术瓣膜修复的严重器质性二尖瓣反流患者。每位患者都接受了术前三维 TTE 和术中三维 TEE 检查，然后进行瓣环成形术。对 TTE 和 TEE 重建的二尖瓣进行比较，并使用专用三维软件（EchoPAC GE-Health-Care Software 3D-auto-MVQ ）重建两种方法重建的瓣环几何形状：结果：三维 TTE 和三维 TEE 在识别病变扇贝方面的准确率相当（总体准确率：三维 TTE 91.8%，三维 TEE 98.1%，P > 0.05）。但是，三维 TTE 在鉴别多发性弦索破裂方面不如三维 TEE（准确率：三维 TTE 80%，三维 TEE 100%）。二尖瓣瓣环的定量分析显示，三维 TTE 和三维 TEE 在静态参数上得出的结果是重叠的（P > 0.05），而在动态参数上则有显著差异（P 结论：三维 TTE 和三维 TEE 在二尖瓣瓣环的定量分析上得出的结果是重叠的（P > 0.05）：在所选人群中，三维 TTE 在识别二尖瓣病变方面的诊断准确性与经食道超声心动图相当。此外，使用专用的三维软件，仅 TTE 就能提供全面、无创的术前评估，尤其是静态瓣环参数。还需要进一步研究来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.