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Journal of Echocardiography

, Volume 12, Issue 1, pp 24–30 | Cite as

Assessment of the aortic valve annular geometry by real-time three-dimensional transthoracic echocardiography: comparison with two-dimensional transthoracic echocardiography and multidetector computed tomography

  • Chikage Oshita
  • Kazuya Murata
  • Yasuaki Wada
  • Tomoko Nao
  • Kosuke Uchida
  • Shinichi Okuda
  • Takehisa Susa
  • Nobuaki Tanaka
  • Masunori Matsuzaki
  • Masafumi Yano
Original Investigation

Abstract

Background

Real-time three-dimensional transthoracic echocardiography (3DTTE) has been developed and provides detailed 3D information, noninvasively. However, the accuracy and usefulness of 3DTTE in the evaluation of aortic root geometry are still not clear.

Methods

2DTTE and 3DTTE were performed in 161 patients with various cardiac diseases. Multidetector computed tomography (MDCT) was performed in 35 of the 161 patients. The diameters and areas of the aortic annulus were evaluated by these three methods and compared. To evaluate the shape of the aortic annuli, eccentricity index (EI) (1 − minimum diameter/long-axis diameter) were calculated.

Results

Maximum dimensions of the aortic annulus measured by MDCT were significantly larger than those by 3DTTE and 2DTTE. The aortic annular areas measured by MDCT and 3DTTE were significantly larger than areas by 2DTTE. A good correlation (r = 0.85) was observed between the areas obtained by 3DTTE and MDCT; however, the correlation between the values by 2DTTE and MDCT was rough (r = 0.44). EI values in 46 % of the patients were greater than 0.1, i.e., the aortic annulus was elliptical.

Conclusion

The images obtained by 3DTTE provided accurate values of the aortic annular area, which were equal to the values measured by MDCT. 3DTTE is a useful method to evaluate the aortic annular geometry.

Keywords

Aortic annulus area 3D transthoracic echocardiography Multidetector computed tomography 3D transesophageal echocardiography 

Notes

Conflict of interest

Chikage Oshita, Kazuya Murata, Yasuaki Wada, Tomoko Nao, Kosuke Uchida, Shinichi Okuda, Takehisa Susa, Nobuaki Tanaka, and Masunori Matsuzaki declare that they have no conflict of interest.

References

  1. 1.
    Tops LF, Wood DA, Delgado V, et al. Noninvasive evaluation of the aortic root with multislice computed tomography implications for transcatheter aortic valve replacement. JACC Cardiovasc Imaging. 2008;1:321–30.PubMedCrossRefGoogle Scholar
  2. 2.
    Schoenhagen P, Tuzcu EM, Kapadia SR, et al. Three-dimensional imaging of the aortic valve and aortic root with computed tomography: new standards in an era of transcatheter valve repair/implantation. Eur Heart J. 2009;30:2079–86.PubMedCrossRefGoogle Scholar
  3. 3.
    Van de Veire NRL. Imaging to guide transcatheter aortic valve implantation. J Echocardiogr. 2010;8:1–6.CrossRefGoogle Scholar
  4. 4.
    Webb JG, Pasupati S, Humphries K, et al. Percutaneous transarterial aortic valve replacement in selected high-risk patients with aortic stenosis. Circulation. 2007;116:755–63.PubMedCrossRefGoogle Scholar
  5. 5.
    Chin D. Echocardiography for transcatheter aortic valve implantation. Eur J Echocardiogr. 2009;10:i21–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Ng AC, Delgado V, van der Kley F, et al. Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circ Cardiovasc Imaging. 2010;3:94–102.PubMedCrossRefGoogle Scholar
  7. 7.
    Burman ED, Keegan J, Kilner PJ. Aortic root measurement by cardiovascular magnetic resonance: specification of planes and lines of measurement and corresponding normal values. Circ Cardiovasc Imaging. 2008;1:104–13.PubMedCrossRefGoogle Scholar
  8. 8.
    Hutter A, Opitz A, Bleiziffer S, et al. Aortic annulus evaluation in transcatheter aortic valve implantation. Catheter Cardiovasc Interv. 2010;76:1009–19.PubMedCrossRefGoogle Scholar
  9. 9.
    Wood DA, Tops LF, Mayo JR, et al. Role of multislice computed tomography in transcatheter aortic valve replacement. Am J Cardiol. 2009;103:1295–301.PubMedCrossRefGoogle Scholar
  10. 10.
    Otani K, Takeuchi M, Kaku K, et al. Assessment of the aortic root using real-time 3D transesophageal echocardiography. Circ J. 2010;74:2649–57.PubMedCrossRefGoogle Scholar
  11. 11.
    Doddamani S, Bello R, Friedman MA, et al. Demonstration of left ventricular outflow tract eccentricity by real time 3D echocardiography: implications for the determination of aortic valve area. Echocardiography. 2007;24:860–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Doddamani S, Grushko MJ, Makaryus AN, et al. Demonstration of left ventricular outflow tract eccentricity by 64-slice multi-detector CT. Int J Cardiovasc Imaging. 2009;25:175–81.PubMedCrossRefGoogle Scholar
  13. 13.
    Moss RR, Ivens E, Pasupati S, et al. Role of echocardiography in percutaneous aortic valve implantation. JACC Cardiovasc Imaging. 2008;1:15–24.PubMedCrossRefGoogle Scholar
  14. 14.
    Piazza N, de Jaegere P, Schultz C, et al. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv. 2008;1:74–81.PubMedCrossRefGoogle Scholar
  15. 15.
    Gaspar T, Adawi S, Sachner R, et al. Three-dimensional imaging of the left ventricular outflow tract: impact on aortic valve area estimation by the continuity equation. J Am Soc Echocardiogr. 2012;25:749–57.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Society of Echocardiography 2013

Authors and Affiliations

  • Chikage Oshita
    • 1
  • Kazuya Murata
    • 2
  • Yasuaki Wada
    • 3
  • Tomoko Nao
    • 1
  • Kosuke Uchida
    • 1
  • Shinichi Okuda
    • 1
  • Takehisa Susa
    • 1
  • Nobuaki Tanaka
    • 4
  • Masunori Matsuzaki
    • 1
  • Masafumi Yano
    • 1
  1. 1.Department of Medicine and Clinical ScienceYamaguchi University Graduate School of MedicineUbeJapan
  2. 2.Murata Cardiovascular ClinicSanyoonodaJapan
  3. 3.Division of Clinical LaboratoryYamaguchi University HospitalUbeJapan
  4. 4.Department of Laboratory ScienceYamaguchi University Graduate School of MedicineUbeJapan

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