CLINICAL-APPLICATION OF TRANSTHORACIC VOLUME-RENDERED 3-DIMENSIONAL ECHOCARDIOGRAPHY IN THE ASSESSMENT OF MITRAL REGURGITATION

Two-dimensional echocardiography (2-DE) and Doppler methods are genera lly used for assessing mechanisms and severity of mitral regurgitation (MR). Recently, 3-dimensional echocardiography (3-DE) has been applie d successfully in various cardiac disorders, bur its value in evaluati ng the mechanism and the severity of MR are not known. We studied 30 p atients with MR using 2-DE and 3-DE. Volume-rendered gray-scale 3-DE i mages of the mitral valve apparatus and MR jets were reconstructed. Ma ximal volume of the MR jet by 3-DE was compared with mitral regurgitan t volume and fraction, regurgitant jet area and the ratio of jet area to left atrial area, and semiquantitative grading derived from 2-DE me thods. Our results demonstrated that 3-DE aided in a better depiction of the mitral apparatus and its abnormalities in 70% of the patients. The origin, direction, and morphology of the MR jet were better deline ated.in 3-DE volumetric display. Quantitative analysis, however, showe d only a weak to moderate correlation between 3-DE maximal MR jet volu me and 2-DE mitral regurgitant volume (y = 0.5x + 11.4, r = 0.7), regu rgitant fraction (y = 0.5x + 8.2, r =0.65), mitral regurgitant jet are a (y = 0.2x + 5, r = 0.51), jet area to left atrial area ratio (7 = 0. 53x + 7.6, r = 0.54), and semiquantitative grading of MR (7 = 9.1x - 1 .8, r = 0.74). In conclusion, 3-DE aids in a better understanding of t he mechanisms of MR and morphology of the regurgitant jets, its quanti tative ability, when reconstruction of the jet alone is used, may be l imited. (C) 1998 by Excerpta Medica,Inc.