Interaliasing distance of the flow convergence surface for determining mitral regurgitant volume

A validation study in a chronic animal model

Marta Sitges, Michael Jones, Takahiro Shiota, David L. Prior, Jian Xin Qin, Hiroyuki Tsujino, Fabrice Bauer, Yong Jin Kim, Dimitri Deserranno, Neil L. Greenberg, Lisa A. Cardon, Arthur D. Zetts, Mario J. Garcia, James D. Thomas

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVES: We aimed to validate a new flow convergence (FC) method that eliminated the need to locate the regurgitant orifice and that could be performed semiautomatedly. BACKGROUND: Complex and time-consuming features of previously validated color Doppler methods for determining mitral regurgitant volume (MRV) have prevented their widespread clinical use. METHODS: Thirty-nine different hemodynamic conditions in 12 sheep with surgically created flail leaflets inducing chronic mitral regurgitation were studied with two-dimensional (2D) echocardiography. Color Doppler M-mode images along the centerline of the accelerating flow towards the mitral regurgitation orifice were obtained. The distance between the two first aliasing boundaries (interaliasing distance [IAD]) was measured and the FC radius was mathematically derived according to the continuity equation (Rcalc = IAD/(1 - √v1v2), v1 and v2 being the aliasing velocities). The conventional 2D FC radius was also measured (Rmeas). Mitral regurgitant volume was then calculated according to the FC method using both Rcalc and Rmeas. Aortic and mitral electromagnetic (EM) flow probes and meters were balanced against each other to determine the reference standard MRV. RESULTS: Mitral regurgitant volume calculated from Rcalc and Rmeas correlated well with EM-MRV (y = 0.83x + 5.17, r = 0.90 and y = 1.04x + 0.91, r = 0.91, respectively, p < 0.001 for both). However, both methods resulted in slight overestimation of EM-MRV (Δ was 3.3 ± 2.1 ml for Rcalc and 1.3 ± 2.3 ml for Rmeas). CONCLUSIONS: Good correlation was observed between MRV derived from Rcalc (IAD method) and EM-MRV, similar to that observed with Rmeas (conventional FC method) and EM-MRV. The Rcalc using the IAD method has an advantage over conventional Rmeas in that it does not require spatial localization of the regurgitant orifice and can be performed semiautomatedly.

Original languageEnglish (US)
Pages (from-to)1195-1202
Number of pages8
JournalJournal of the American College of Cardiology
Volume38
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

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Validation Studies
Electromagnetic Phenomena
Animal Models
Mitral Valve Insufficiency
Echocardiography
Color
Sheep
Hemodynamics

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Interaliasing distance of the flow convergence surface for determining mitral regurgitant volume : A validation study in a chronic animal model. / Sitges, Marta; Jones, Michael; Shiota, Takahiro; Prior, David L.; Qin, Jian Xin; Tsujino, Hiroyuki; Bauer, Fabrice; Kim, Yong Jin; Deserranno, Dimitri; Greenberg, Neil L.; Cardon, Lisa A.; Zetts, Arthur D.; Garcia, Mario J.; Thomas, James D.

In: Journal of the American College of Cardiology, Vol. 38, No. 4, 2001, p. 1195-1202.

Research output: Contribution to journalArticle

Sitges, M, Jones, M, Shiota, T, Prior, DL, Qin, JX, Tsujino, H, Bauer, F, Kim, YJ, Deserranno, D, Greenberg, NL, Cardon, LA, Zetts, AD, Garcia, MJ & Thomas, JD 2001, 'Interaliasing distance of the flow convergence surface for determining mitral regurgitant volume: A validation study in a chronic animal model', Journal of the American College of Cardiology, vol. 38, no. 4, pp. 1195-1202. https://doi.org/10.1016/S0735-1097(01)01502-9
Sitges, Marta ; Jones, Michael ; Shiota, Takahiro ; Prior, David L. ; Qin, Jian Xin ; Tsujino, Hiroyuki ; Bauer, Fabrice ; Kim, Yong Jin ; Deserranno, Dimitri ; Greenberg, Neil L. ; Cardon, Lisa A. ; Zetts, Arthur D. ; Garcia, Mario J. ; Thomas, James D. / Interaliasing distance of the flow convergence surface for determining mitral regurgitant volume : A validation study in a chronic animal model. In: Journal of the American College of Cardiology. 2001 ; Vol. 38, No. 4. pp. 1195-1202.
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abstract = "OBJECTIVES: We aimed to validate a new flow convergence (FC) method that eliminated the need to locate the regurgitant orifice and that could be performed semiautomatedly. BACKGROUND: Complex and time-consuming features of previously validated color Doppler methods for determining mitral regurgitant volume (MRV) have prevented their widespread clinical use. METHODS: Thirty-nine different hemodynamic conditions in 12 sheep with surgically created flail leaflets inducing chronic mitral regurgitation were studied with two-dimensional (2D) echocardiography. Color Doppler M-mode images along the centerline of the accelerating flow towards the mitral regurgitation orifice were obtained. The distance between the two first aliasing boundaries (interaliasing distance [IAD]) was measured and the FC radius was mathematically derived according to the continuity equation (Rcalc = IAD/(1 - √v1v2), v1 and v2 being the aliasing velocities). The conventional 2D FC radius was also measured (Rmeas). Mitral regurgitant volume was then calculated according to the FC method using both Rcalc and Rmeas. Aortic and mitral electromagnetic (EM) flow probes and meters were balanced against each other to determine the reference standard MRV. RESULTS: Mitral regurgitant volume calculated from Rcalc and Rmeas correlated well with EM-MRV (y = 0.83x + 5.17, r = 0.90 and y = 1.04x + 0.91, r = 0.91, respectively, p < 0.001 for both). However, both methods resulted in slight overestimation of EM-MRV (Δ was 3.3 ± 2.1 ml for Rcalc and 1.3 ± 2.3 ml for Rmeas). CONCLUSIONS: Good correlation was observed between MRV derived from Rcalc (IAD method) and EM-MRV, similar to that observed with Rmeas (conventional FC method) and EM-MRV. The Rcalc using the IAD method has an advantage over conventional Rmeas in that it does not require spatial localization of the regurgitant orifice and can be performed semiautomatedly.",
author = "Marta Sitges and Michael Jones and Takahiro Shiota and Prior, {David L.} and Qin, {Jian Xin} and Hiroyuki Tsujino and Fabrice Bauer and Kim, {Yong Jin} and Dimitri Deserranno and Greenberg, {Neil L.} and Cardon, {Lisa A.} and Zetts, {Arthur D.} and Garcia, {Mario J.} and Thomas, {James D.}",
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T1 - Interaliasing distance of the flow convergence surface for determining mitral regurgitant volume

T2 - A validation study in a chronic animal model

AU - Sitges, Marta

AU - Jones, Michael

AU - Shiota, Takahiro

AU - Prior, David L.

AU - Qin, Jian Xin

AU - Tsujino, Hiroyuki

AU - Bauer, Fabrice

AU - Kim, Yong Jin

AU - Deserranno, Dimitri

AU - Greenberg, Neil L.

AU - Cardon, Lisa A.

AU - Zetts, Arthur D.

AU - Garcia, Mario J.

AU - Thomas, James D.

PY - 2001

Y1 - 2001

N2 - OBJECTIVES: We aimed to validate a new flow convergence (FC) method that eliminated the need to locate the regurgitant orifice and that could be performed semiautomatedly. BACKGROUND: Complex and time-consuming features of previously validated color Doppler methods for determining mitral regurgitant volume (MRV) have prevented their widespread clinical use. METHODS: Thirty-nine different hemodynamic conditions in 12 sheep with surgically created flail leaflets inducing chronic mitral regurgitation were studied with two-dimensional (2D) echocardiography. Color Doppler M-mode images along the centerline of the accelerating flow towards the mitral regurgitation orifice were obtained. The distance between the two first aliasing boundaries (interaliasing distance [IAD]) was measured and the FC radius was mathematically derived according to the continuity equation (Rcalc = IAD/(1 - √v1v2), v1 and v2 being the aliasing velocities). The conventional 2D FC radius was also measured (Rmeas). Mitral regurgitant volume was then calculated according to the FC method using both Rcalc and Rmeas. Aortic and mitral electromagnetic (EM) flow probes and meters were balanced against each other to determine the reference standard MRV. RESULTS: Mitral regurgitant volume calculated from Rcalc and Rmeas correlated well with EM-MRV (y = 0.83x + 5.17, r = 0.90 and y = 1.04x + 0.91, r = 0.91, respectively, p < 0.001 for both). However, both methods resulted in slight overestimation of EM-MRV (Δ was 3.3 ± 2.1 ml for Rcalc and 1.3 ± 2.3 ml for Rmeas). CONCLUSIONS: Good correlation was observed between MRV derived from Rcalc (IAD method) and EM-MRV, similar to that observed with Rmeas (conventional FC method) and EM-MRV. The Rcalc using the IAD method has an advantage over conventional Rmeas in that it does not require spatial localization of the regurgitant orifice and can be performed semiautomatedly.

AB - OBJECTIVES: We aimed to validate a new flow convergence (FC) method that eliminated the need to locate the regurgitant orifice and that could be performed semiautomatedly. BACKGROUND: Complex and time-consuming features of previously validated color Doppler methods for determining mitral regurgitant volume (MRV) have prevented their widespread clinical use. METHODS: Thirty-nine different hemodynamic conditions in 12 sheep with surgically created flail leaflets inducing chronic mitral regurgitation were studied with two-dimensional (2D) echocardiography. Color Doppler M-mode images along the centerline of the accelerating flow towards the mitral regurgitation orifice were obtained. The distance between the two first aliasing boundaries (interaliasing distance [IAD]) was measured and the FC radius was mathematically derived according to the continuity equation (Rcalc = IAD/(1 - √v1v2), v1 and v2 being the aliasing velocities). The conventional 2D FC radius was also measured (Rmeas). Mitral regurgitant volume was then calculated according to the FC method using both Rcalc and Rmeas. Aortic and mitral electromagnetic (EM) flow probes and meters were balanced against each other to determine the reference standard MRV. RESULTS: Mitral regurgitant volume calculated from Rcalc and Rmeas correlated well with EM-MRV (y = 0.83x + 5.17, r = 0.90 and y = 1.04x + 0.91, r = 0.91, respectively, p < 0.001 for both). However, both methods resulted in slight overestimation of EM-MRV (Δ was 3.3 ± 2.1 ml for Rcalc and 1.3 ± 2.3 ml for Rmeas). CONCLUSIONS: Good correlation was observed between MRV derived from Rcalc (IAD method) and EM-MRV, similar to that observed with Rmeas (conventional FC method) and EM-MRV. The Rcalc using the IAD method has an advantage over conventional Rmeas in that it does not require spatial localization of the regurgitant orifice and can be performed semiautomatedly.

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