Abstract 15269: Automated Quantification of Mitral Regurgitation by 3D PISA Using Real Time Three Dimensional Volume Echocardiography: Comparisons with 2D PISA and Magnetic Resonance Imaging

Abstract

Background: Accurate assessment of mitral regurgitation (MR) severity is the key for the clinical decision-making to optimize patient outcomes. Recent advances in real-time 3D echocardiography provide the option of automated quantification of MR by 3D PISA volume measurements. The purpose of this study was to explore the feasibility and accuracy of automated quantification of MR by 3D PISA, comparing with conventional 2D Doppler echocardiography and phase contrast cardiac magnetic resonance (PC-CMR) imaging as a reference.

Methods: From December 2011 to May 2012, sixteen patients with moderate to severe MR and scheduled for mitral valve surgery who underwent transthoracic echocardiography (TTE) and PC-CMR were enrolled in this study. MR volume of all patients measured by 2D-PISA method and 3D-PISA method was subsequently obtained by dedicated software to quantify the MR volume. MR volume was also measured using PC-CMR. All these measurements of each patient were obtained in the same day.

Results: MR quantification using 3D-PISA was feasible in all patients of this study. Differences in MR volume of PC-CMR with 3D-PISA and 2D-PISA were 6.2± 21.3, 3.3 ± 39.9 mL, respectively (p=0.28). There was excellent correlation between PC-CMR measured MR volume and 3D-PISA measured MR volume (r=0.73, p=0.01). Compared with PC-CMR, Bland-Altman analysis for 3D-PISA showed better agreement (2 standard deviation (SD): 21.3ml) than 2D-PISA (39.9ml) (Figure).

Conclusion: Automated quantification of MR volume with 3D-PISA is feasible and accurate. It should be a promising tool in the evaluation of patients with MR.