A novel new 3D volume echo derived method for regurgitation fraction quantification in isolated aortic regurgitation

IF 18 Q4 Medicine

Archives of Cardiovascular Diseases Supplements Pub Date : 2023-06-01 DOI:10.1016/j.acvdsp.2023.04.023

V. Baland, N. Pace, C. Selton Suty, A. Fraix, O. Huttin, D. Mandry, L. Filippetti

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引用次数: 0

Abstract

Introduction

Accurate quantification of chronic aortic regurgitation (AR) using 2D-TTE is sometimes challenging. Cardiac magnetic resonance imaging (CMR) is increasingly used to refine this assessment by estimating measurement of regurgitation fraction (RF), but remains not widely available. 3D echocardiography (3D-ETT) allows a non-invasive approach of right ventricular (RV) and left ventricular (LV) volumes with a good correlation with CMR measurements. The 3D-TTE volume method is based on the comparison of RV and LV stroke volumes, which is then used to calculate the RF of the aortic valve in isolated AR.The primary objective of this study was to investigate the ability of 3D-TTE to assess the severity of chronic AR based on the criterion of regurgitation fraction (RF) obtained by the volume method in comparison to PC-CMR.

Method

We enrolled 42 patients with isolated AR who underwent ASE algorithm-guided 2D echocardiography (2D-TTE), 3D echocardiography and CMR. Regurgitation fraction (RF) was calculated by 3D-TTE using the formula [(LV Stroke Volume–RV Stroke Volume)/LV Stroke Volume] × 100. Correlation and concordance between 3D-TTE-RF and PC-CMR-RF were analyzed. Reproducibility of 3D-TTE-RF measurement was evaluated.

Results

Seven (17%) had mild AR, 27 (64%) moderate AR, and 8 (19%) severe AR in PC-CMR. Mean RF was 32.7 ± 13.9% by 3D-TTE and 30,7 ± 14,9% by PC-CMR-RF (P < 0,05). 3D-TTE-RF and PC-CMR-RF had a good correlation (r = 0.90, P < 0,05). We found a good intra-operator (r:0.95, P < 0.05) and inter-operator (r:0.87, P < 0.05) reproductibility. The final gradation of AR was concordant between 3D TTE and PC-CMR in 88% of the cases.

Conclusion

The assessment of isolated aortic regurgitation fraction in 3D-TTE by the volumetric method is a feasible and reproducible method in daily clinical practice, with a good correlation to PC-CMR. Estimation of the aortic regurgitation fraction in (Fig. 1).

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一种新的三维体积回波衍生方法用于孤立主动脉反流的定量分析

使用2D-TTE对慢性主动脉反流(AR)进行准确量化有时是具有挑战性的。心脏磁共振成像(CMR)越来越多地用于通过估计反流分数(RF)的测量来完善这一评估，但仍未广泛应用。3D超声心动图(3D- ett)允许无创入路右心室(RV)和左心室(LV)容量与CMR测量具有良好的相关性。3D-TTE容积法是基于左室和左室卒中容积的比较，然后用于计算孤立性AR的主动脉瓣RF。本研究的主要目的是研究3D-TTE基于容积法获得的反流分数(RF)标准来评估慢性AR严重程度的能力，并与PC-CMR进行比较。方法我们招募了42例孤立性AR患者，他们接受了ASE算法引导的2D超声心动图(2D- tte)、3D超声心动图和CMR。采用3D-TTE计算回流分数(RF)，计算公式为[(左室行程容积-右室行程容积)/左室行程容积]× 100。分析了3D-TTE-RF与PC-CMR-RF的相关性和一致性。对3D-TTE-RF测量的再现性进行了评价。结果PC-CMR轻度AR 7例(17%)，中度AR 27例(64%)，重度AR 8例(19%)。3D-TTE的平均RF为32.7±13.9%，PC-CMR-RF为30.7±14.9% (P <0 05)。3D-TTE-RF与PC-CMR-RF具有良好的相关性(r = 0.90, P <0 05)。我们发现了一个很好的内算子(r:0.95, P <0.05)和算子间(r:0.87, P <0.05)复现。在88%的病例中，3D TTE和PC-CMR的最终AR分级是一致的。结论体积法评估3D-TTE离体主动脉反流分数在日常临床实践中是一种可行且可重复的方法，与PC-CMR具有良好的相关性。估计主动脉反流分数(图1)。

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

Archives of Cardiovascular Diseases Supplements CARDIAC & CARDIOVASCULAR SYSTEMS-

自引率

0.00%

发文量

508

期刊介绍： Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.