SEVERITY OF AORTIC REGURGITATION ASSESSED BY AREA OF VENA CONTRACTA- A CLINICAL COLOR DOPPLER IMAGING STUDY
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Vena contracta
Color doppler
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Abstract Purpose The precise assessment of tricuspid regurgitation (TR) using 2D imaging techniques may be associated with significant difficulties due to the nonround regurgitation area. Direct analysis of the regurgitation area by 3D color Doppler echocardiography at the vena contracta (3D VCA) has the potential to adequately quantify even complex TR. This study compared 3D VCA for quantification of the TR with the regurgitant area determined by proximal isovolumetric convergence method (PISA‐EROA) considering different clinical settings. Methods In 95 patients with TR of different severity, the regurgitant orifice area was determined by 3D color Doppler echocardiography and by PISA‐EROA. Using 3D color Doppler echocardiography, the regurgitant orifice area was determined three times in each patient considering 3 datasets. Results Mean 3D VCA was 0.27 ± 0.14, 0.27 ± 0.13, and 0.29 ± 0.14 cm 2 , respectively, as determined by three separate measurements in each of the 95 patients. There was a mean relative deviation between the three measurements in each patient of 12.4 ± 14.9%. The regurgitant orifice area using the PISA method was 0.28 ± 0.14 cm 2 . There was a mean difference of 0.07 cm 2 (95% CI −0.124 to 0.138 cm 2 ) between 3D VCA and PISA‐EROA. The correlation between 3D VCA and PISA‐EROA was r = .88 ( P < .001). Considering a grading of TR severity in grade I (regurgitant area < 0.2 cm 2 ), grade II (area 0.2–0.4 cm 2 ), and grade III (area > 0.4 cm 2 ), there was a good agreement between severity grade determined by 3D VCA and severity grade determined by PISA‐EROA (kappa 0.71). Conclusion The analysis of the VCA of a TR using 3D color Doppler echocardiography is an alternative method to determine the regurgitant severity with good agreement to the PISA method.
Vena contracta
Color doppler
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Vena contracta
Ventricular pressure
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Purpose of review Current three-dimensional echocardiographic technology, including live three-dimensional transesophageal echocardiography and single-beat three-dimensional color Doppler imaging, are providing valuable new insight into the mechanism and quantification of mitral valve regurgitation. Recent findings We discuss recent applications of three-dimensional volumetric leaflet imaging with emphasis on the distinction between organic and functional mitral regurgitation. We also discuss the added benefit of current and emerging three-dimensional color Doppler methods for the quantification of mitral valve regurgitation severity. The limitations of the two-dimensional proximal isovelocity surface area method are discussed, along with potential solutions provided by three-dimensional color Doppler imaging methods. Methods to directly measure the regurgitant jet vena contracta area are presented, along with recent clinical studies comparing this method with two-dimensional Doppler and cardiac MRI reference standards. Summary The use of three-dimensional color Doppler methods has now been well validated for the accurate and reproducible quantification of mitral valve regurgitation severity. These newer tools are now clinically available and should be incorporated into the routine Doppler assessment of mitral valve regurgitation severity.
Mitral valve regurgitation
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Vena contracta
Color doppler
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Color doppler
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Vena contracta
Color doppler
Pulsatile flow
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Objective:To explore the roles of color Doppler vena contracta in the evaluation of mitral regurgitation grad-ing.Methods:30 cases of mitral regurgitation patients were studied by color Doppler to detect the vena contracta,jet length,jet area and instantaneous jet volume,then to compare the parameters between mild and moderate patients,and between moderate and severe mitral.Results:Mitral regurgitation in mild was(2.57±0.40) mm,in moderate was(3.23± 0.36) mm,in severe mitral was(5.52±1.10) mm.There was a significant difference between each group(P0.01～0.001).The correlation coefficient between color Doppler vena contracta,jet length,jet area,instantaneous jet volume and effective mi-tral orifice area were 0.85(P0.001),0.48(P0.01),0.69(P0.001),0.69(P0.001) respectively.Conclusion:Color Doppler vena contracta is less affected by hemodynamics and can more accurately estimate the jet size of mitral regurgitation grading.
Vena contracta
Color doppler
Grading (engineering)
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Vena contracta
Venous return curve
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