Three-dimensional color Doppler: A clinical study in patients with mitral regurgitation

OBJECTIVES The purpose of this study was to assess the clinical feasibility of three-dimensional (3D) reconstruction of color Doppler signals in patie nts with mitral regurgitation. BACKGROUND Two-dimensional (2D) color Doppler has limited value in visualiz ing and quantifying asymmetric mitral regurgitation. Clinical studies on 3D reconstruction of Doppler signals in original color coding have not yet be en performed in patients. We have developed a new procedure for 3D reconstr uction of color Doppler. METHODS We studied 58 patients by transesophageal 3D echocardiography. The jet area was assessed by planimetry and the jet volumes by 3D Doppler. The regurgitant fractions, the volumes, and the angiographic degree of mitral r egurgitation were assessed in 28 patients with central jets and compared wi th those of 30 patients with eccentric jets. RESULTS In all patients, jet areas and jet volumes significantly correlated with the angiographic grading (r = 0.73 and r = 0.90), the regurgitant fra ction (r = 0.68 and r = 0.80) and the regurgitant volume (r = 0.66 and r = 0.90). In patients with central jets, significant correlations were found b etween jet area and angiography (r = 0.86), regurgitant fraction (r = 0.64) and regurgitant volume (r = 0.78). No significant correlations were found between jet area and angiography (r = 0.53), regurgitant fraction (r = 0.52 ) and regurgitant volume (r = 0.53) in the group of patients with eccentric jets. In contrast, jet volumes significantly correlated with angiography ( r = 0.90), regurgitant fraction (r = 0.75)and regurgitant volume (r = 0.88) in the group of patients with eccentric jets. CONCLUSIONS Three-dimensional Doppler revealed new images of the complex je t geometry. In addition, jet volumes, assessed by an automated voxel count, independent of manual planimetry or subjective estimation, showed that 3D Doppler is also capable of quantifying asymmetric jets. (C) 1999 by the Ame rican College of Cardiology.