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Quantification of mitral valve regurgitation with color flow Doppler using baseline shift

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Abstract

Vena contracta width (VCW) and effective regurgitant orifice area (EROA) are well established methods for evaluating mitral regurgitation using transesophageal echocardiography (TEE). For color-flow Doppler (CF) measurements Nyquist limit of 50–60 cm/s is recommended. Aim of the study was to investigate the effectiveness of a baseline shift of the Nyquist limit for these measurements. After a comprehensive 2-dimensional (2D) TEE examination, the mitral regurgitation jet was acquired with a Nyquist limit of 50 cm/s (NL50) along with a baseline shift to 37.5 cm/s (NL37.5) using CF. Moreover a real time 3-dimensional (RT 3D) color complete volume dataset was stored with a Nyquist limit of 50 cm/s (NL50) and 37.5 cm/s (NL37.5). Vena contracta width (VCW) as well as Proximal Isovelocity Surface Area (PISA) derived EROA were measured based on 2D TEE and compared to RT 3D echo measurements for vena contracta area (VCA) using planimetry method. Correlation between VCA 3D NL50 and VCW NL50 was 0.29 (p < 0.05) compared to 0.6 (p < 0.05) using NL37.5. Correlation between VCA 3D NL50 and EROA 2D NL50 was 0.46 (p < 0.05) vs. 0.6 (p < 0.05) EROA 2D NL37.5. Correlation between VCA 3D NL37.5 and VCW NL50 was 0.45 (p < 0.05) compared to 0.65 (p < 0.05) using VCW NL37.5. Correlation between VCA 3D NL37.5 and EROA 2D NL50 was 0.41 (p < 0.05) vs. 0.53 (p < 0.05) using EROA 2D NL37.5. Baseline shift of the NL to 37.5 cm/s improves the correlation for VCW and EROA when compared to RT 3D NL50 planimetry of the vena contracta area. Baseline shift in RT 3D to a NL of 37.5 cm/s shows similar results like NL50.

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Abbreviations

VC:

Vena contracta

EROA:

Effective regurgitant orifice area

VCA:

Vena contracta area

TEE:

Transesophageal echocardiography

2D:

Two dimensional

3D:

Three dimensional

NL50:

Nyquist limit 50 cm/s

NL37.5:

Nyquist limit 37.5 cm/s

MR:

Mitral regurgitation

LA:

Left atrium

LV:

Left ventricle

CF:

Color flow

PW:

Pulsed wave

VCW:

Vena contracta width

CW:

Continuous wave

PISA:

Proximal isovelocity surface area

RT:

Realtime

MV:

Mitral valve

ME:

Midesophageal

LAX:

Long axis

ICC:

Intraclass correlation coefficient

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, Heartcenter, University Leipzig, Leipzig, Germany

    Hannah Heß, Sarah Eibel, Chirojit Mukherjee, Udo X. Kaisers & Joerg Ender

  2. Department of Anesthesiology and Intensive Care Medicine Medical Faculty, University Leipzig, Leipzig, Germany

    Udo X. Kaisers

  3. Department of Anesthesiology and Intensive Medicine II, Heart Center Leipzig, University of Leipzig, Struempellstrasse 39, 04289, Leipzig, Germany

    Joerg Ender

Authors
  1. Hannah Heß
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  2. Sarah Eibel
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  3. Chirojit Mukherjee
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  4. Udo X. Kaisers
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  5. Joerg Ender
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Correspondence to Joerg Ender.

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Hannah Heß and Sarah Eibel have equally contributed to the manuscript.

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Heß, H., Eibel, S., Mukherjee, C. et al. Quantification of mitral valve regurgitation with color flow Doppler using baseline shift. Int J Cardiovasc Imaging 29, 267–274 (2013). https://doi.org/10.1007/s10554-012-0084-7

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  • DOI: https://doi.org/10.1007/s10554-012-0084-7

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