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[Quantification of aortic valve area using three-dimensional echocardiography].

Leopoldo Pérez de Isla1, José Zamorano, Rocío Pérez de la Yglesia

  • 1Unidad de Imagen Cardiovascular, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, España.

Revista Espanola De Cardiologia
|May 9, 2008
PubMed
Summary

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Three-dimensional echocardiography (3D-echo) offers more reproducible measurements of the left ventricular outflow tract (LVOT) area compared to 2D-echo. This improved accuracy may enhance the assessment of valvular aortic stenosis severity.

Area of Science:

  • Cardiovascular Imaging
  • Echocardiography
  • Cardiac Surgery

Background:

  • Accurate measurement of the left ventricular outflow tract (LVOT) area is crucial for assessing valvular aortic stenosis severity.
  • Conventional 2D echocardiography (2D-echo) has limitations in reproducibility for LVOT area measurements.
  • Three-dimensional echocardiography (3D-echo) offers potential for improved spatial assessment of cardiac structures.

Purpose of the Study:

  • To compare the reproducibility of LVOT area measurements between 3D-echo and 2D-echo.
  • To determine the LVOT circularity index using 3D-echo.
  • To evaluate the utility of 3D-echo LVOT area measurements in quantifying valvular aortic stenosis severity.

Main Methods:

  • 40 patients (22 with aortic stenosis) underwent LVOT area measurements using both 2D-echo and 3D-echo.

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  • LVOT circularity index was calculated using 3D-echo.
  • Valvular aortic stenosis severity was categorized using both 2D-echo and 3D-echo methods.

    • Main Results:

    • 3D-echo demonstrated superior inter- and intra-observer agreement for LVOT area measurements compared to 2D-echo.
    • The LVOT circularity index was 1.50 (0.25) and showed poor correlation with LVOT area (r=-0.34).
    • Agreement in categorizing stenosis severity between 2D-echo and 3D-echo was poor (kappa=0.36).

    Conclusions:

    • 3D-echo provides more reproducible LVOT area measurements than 2D-echo, suggesting it as a preferred technique.
    • 3D-echo reveals an elliptical LVOT shape, independent of its size and circularity.
    • 3D-echo may aid in classifying the severity of valvular aortic stenosis.