Clinical Impact of the Volumetric Quantification of Ventricular Secondary Mitral Regurgitation by Three-dimensional Echocardiography.
effective regurgitant orifice area
heart failure hospitalization
left ventricular function
prognosis
regurgitant volume
secondary mitral regurgitation
Journal
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388
Informations de publication
Date de publication:
18 Jan 2024
18 Jan 2024
Historique:
received:
20
09
2023
revised:
08
01
2024
accepted:
09
01
2024
medline:
21
1
2024
pubmed:
21
1
2024
entrez:
20
1
2024
Statut:
aheadofprint
Résumé
The assessment of ventricular secondary mitral regurgitation (v-SMR) severity through effective regurgitant orifice area (EROA) and regurgitant volume (RegVol) calculations using the proximal isovelocity surface area (PISA) method and the two-dimensional echocardiography volumetric method (2DEVM) is prone to underestimation. Accordingly, we sought to investigate the accuracy of the three-dimensional echocardiography volumetric method (3DEVM) and its association with outcomes in v-SMR patients. We included 229 patients (70 ± 13 years, 74% men) with v-SMR. We compared EROA and RegVol calculated by 3DEVM, 2DEVM, and PISA methods. The endpoint was a composite of heart failure hospitalization and death for any cause. After a mean follow-up of 20 ± 11 months, 98 patients (43%) reached the endpoint. RegVol and EROA calculated by 3DEVM were larger than those calculated by 2DEVM and PISA. Using ROC curve analysis, both EROA [Area Under the Curve (AUC) 0.75 (95% CI 0.68-0.81)] (p=0.008) and RegVol (AUC 0.75 (95% CI 0.68-0.82) (p=0.02) measured by 3DEVM showed the highest association with the outcome at 2 years compared to PISA and 2DEVM (p<0.05 for all). Kaplan-Meier analysis demonstrated a significantly higher rate of events in patients with EROA≥0.3 cm EROA and RegVol calculated by 3DEVM were independently associated with the endpoint, improving the risk stratification of patients with v-SMR compared to 2DEVM and PISA methods.
Sections du résumé
BACKGROUND
BACKGROUND
The assessment of ventricular secondary mitral regurgitation (v-SMR) severity through effective regurgitant orifice area (EROA) and regurgitant volume (RegVol) calculations using the proximal isovelocity surface area (PISA) method and the two-dimensional echocardiography volumetric method (2DEVM) is prone to underestimation. Accordingly, we sought to investigate the accuracy of the three-dimensional echocardiography volumetric method (3DEVM) and its association with outcomes in v-SMR patients.
METHODS
METHODS
We included 229 patients (70 ± 13 years, 74% men) with v-SMR. We compared EROA and RegVol calculated by 3DEVM, 2DEVM, and PISA methods. The endpoint was a composite of heart failure hospitalization and death for any cause.
RESULTS
RESULTS
After a mean follow-up of 20 ± 11 months, 98 patients (43%) reached the endpoint. RegVol and EROA calculated by 3DEVM were larger than those calculated by 2DEVM and PISA. Using ROC curve analysis, both EROA [Area Under the Curve (AUC) 0.75 (95% CI 0.68-0.81)] (p=0.008) and RegVol (AUC 0.75 (95% CI 0.68-0.82) (p=0.02) measured by 3DEVM showed the highest association with the outcome at 2 years compared to PISA and 2DEVM (p<0.05 for all). Kaplan-Meier analysis demonstrated a significantly higher rate of events in patients with EROA≥0.3 cm
CONCLUSIONS
CONCLUSIONS
EROA and RegVol calculated by 3DEVM were independently associated with the endpoint, improving the risk stratification of patients with v-SMR compared to 2DEVM and PISA methods.
Identifiants
pubmed: 38244817
pii: S0894-7317(24)00007-5
doi: 10.1016/j.echo.2024.01.004
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.