Related Experiment Video
Updated: Nov 9, 2025
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Comparison between 2D and 3D Echocardiographic Parameters used for Diagnostic and Therapeutic Purpose in Patients
S S Shakil1, D K Adhikary, S Nahar
1Dr Shiblee Sadeque Shakil, Senior Consultant, Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh;
Insights
Three-dimensional echocardiography offers superior visualization for assessing rheumatic mitral stenosis severity, improving diagnosis and management. This advanced technique better identifies calcification and subvalvular involvement compared to traditional 2D methods.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Rheumatic heart disease (RHD) remains a significant cause of morbidity and mortality, particularly in South Asia.
- Rheumatic mitral stenosis (MS) is the most common manifestation of RHD, requiring accurate severity assessment for effective treatment.
- Conventional 2D echocardiography (2DE) is standard, but 3D echocardiography (3DE) offers enhanced visualization of the heart's complex structures.
Purpose of the Study:
- To compare the diagnostic capabilities of 2D and 3D echocardiography in assessing the severity of rheumatic mitral stenosis.
- To evaluate the utility of 3DE in identifying specific valvular and subvalvular abnormalities in rheumatic MS.
- To determine if 3DE provides a more comprehensive assessment for therapeutic planning in chronic rheumatic MS.
Main Methods:
- A cross-sectional observational study involving 50 subjects with rheumatic mitral stenosis.
- Transthoracic 2D and 3D echocardiography were performed for detailed assessment of mitral valve apparatus.
- Statistical analysis was used to compare the findings between 2DE and 3DE.
Main Results:
- Mitral valvular area measurements were similar between 2DE and 3DE (0.98±0.24cm² vs. 0.92±0.23cm²).
- 3DE demonstrated superior detection of calcification extent and commissural involvement (p=0.002).
- 3DE provided better visualization of subvalvular involvement, particularly chordal adhesion (p<0.001).
Conclusions:
- Three-dimensional echocardiography offers significant advantages over 2D echocardiography for assessing rheumatic mitral stenosis.
- 3DE enhances the identification of key pathological features crucial for treatment decisions.
- 3DE is a promising adjuvant tool for accurate diagnosis, management planning, and complication prediction in chronic rheumatic MS.
Abstract:
Rheumatic heart disease causes a substantial number of morbidity and mortality in South Asia. With the increasing urbanization & antibiotic availability, it is now in declining trends. The prevalence of Rheumatic Fever and Chronic Rheumatic Heart Disease in Bangladesh is 0.6 and 0.3 per thousand populations, respectively. Mitral valve is mostly involved in the rheumatic process, particularly in the form of mitral stenosis. Treatment options of mitral stenosis depend upon the severity of the disease. Echocardiography has a key role in determining the pattern, extent and severity of the involvement of the mitral valve apparatus. 2D and Doppler echocardiography are conventionally used. 3D echocardiography is more available nowadays. The heart being a complex three-dimensional structure, a 3D evaluation would definitely offer better visualization for accurate assessment of the severity of rheumatic mitral stenosis. There are many echocardiography based scoring systems are available for the assessment of the severity of rheumatic MS. Those are mostly 2DE based; among them, Wilkins is widely practiced. Real-time 3DE based score for mitral stenosis is developed recently. This cross-sectional observational study was done in the University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from May 2012 to October 2012. Considering all ethical issues, data were collected from 50 subjects who underwent transthoracic 2D and 3D Echocardiography for the assessment of the extent and severity of mitral stenosis. Precise measurement of the mitral valvular area is of a pivotal role in the assessment of severity, which is found almost similar by both 2DE (0.98±0.24cm²) and 3DE (0.92±0.23cm²). But in identifying calcification and its extent specifically commissural involvement is better detected by 3DE (p=0.002). Detail assessment of subvalvular involvement particularly chordal adhesion can better be done by 3DE (p<0.001). All of these have important contributions in formulating the most favorable therapeutic roadmap in chronic rheumatic MS. To make an efficient management plan and also for the confident prediction of complications, three-dimensional echocardiography has promising prospects and should be considered as an important adjuvant to the conventional two-dimensional echocardiography.
More Related Videos
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:26Mitral Stenosis III: Medical Management
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
01:22Mitral Valve Prolapse II: Assessment and Management
01:25Mitral Regurgitation III: Medical Management