Three-Dimensional Color Doppler Echocardiographic Quantification of Tricuspid Regurgitation Orifice Area: Comparison with Conventional Two-Dimensional Measures
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Vena contracta
Color doppler
Vena contracta
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The effects of orifice nozzle plate thickness on orifice free jet characteristics were investigated experimentally. Hot-wire measurements of velocity distribution were conducted at Re=1.5×10^4 for different orifice plate thickness t/d_0≒0.01-1.5 (d_0: nozzle diameter). A Comparison with pipe jet having a fully developed turbulent pipe flow was also performed. The effects of vena contracta were apparently observed for small t and flow behavior similar to the pipe jet was seen as increasing t. Sudden increase of the jet center turbulent intensity at the nozzle exit occurred for the jet of t/d_0≒0.5, which has the shortest potential core length and the lowest dominant frequency than the other jets. It is also found that the jet of t/d_0≒0.5 spreads remarkably. This indicates that the jet from the orifice plate thickness t/d_0≒0.5 could fluctuate unsteadily at the nozzle exit.
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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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Vena contracta
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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
Flow coefficient
Orifice plate
Discharge coefficient
Flow conditioning
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