M. Jullien , M. Urena , D. Himbert , C. Nguyen , E. Brochet , P. Ou , B. Iung
{"title":"经导管二尖瓣植入术后二尖瓣面积的多模式成像评估：三维超声心动图和CT扫描研究","authors":"M. Jullien , M. Urena , D. Himbert , C. Nguyen , E. Brochet , P. Ou , B. Iung","doi":"10.1016/j.acvdsp.2023.04.022","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The assessment of mitral bioprosthetic area remains a technical challenge, and its calculation by the continuity equation using transthoracic echocardiography<span> (TTE) may be invalidated in several situations, especially after transcatheter mitral valve<span> implantation (TMVI). This study aims to develop a new technique to measure the mitral valve area after a TMVI using a multimodal three-dimensional echocardiographic and computed tomography (CT) approach.</span></span></p></div><div><h3>Method</h3><p><span>Among the patients hospitalized for TMVI at Bichat Hospital between June 2017 and February 2021, we selected 24 who had both a transesophageal echocardiography (TEE) and a </span>cardiac CT after TMVI and before discharge. We performed two area measurements by planimetry: the geometric orifice area (GOA) corresponding to the area delimited by the edges of the open valve leaflets after alignment in the plane of the proximal coaptation point of the bioprosthesis leaflets; and the smallest valve area (SVA) defined by the smallest measurable area of the open prosthesis, at the free edges of the leaflets.</p></div><div><h3>Results</h3><p>In our cohort, the GOA was 1.73<!--> <!-->±<!--> <!-->0.41<!--> <!-->cm<sup>2</sup> on 3D TEE and 1.75<!--> <!-->±<!--> <!-->0.42<!--> <!-->cm<sup>2</sup> on CT. The SVA was 1.40<!--> <!-->±<!--> <!-->0.31<!--> <!-->cm<sup>2</sup> on 3D TEE and 1.49<!--> <!-->±<!--> <!-->0.37<!--> <!-->cm<sup>2</sup> on CT. There was a good agreement between the two techniques for GOA and SVA (ICC<!--> <!-->><!--> <!-->0.6, <em>P</em> <!--><<!--> <!-->0.01) and a good correlation between the two measurements on 3D TEE as well as on CT (Pearson 0.88 and 0.91 respectively, <em>P</em> <!--><<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p><span>Our work suggests a new approach to multimodal assessment of prosthetic mitral valve area after TMVI, using 3D TEE and CT scan. Further studies are needed to complete our results, especially to confirm the feasibility and reproducibility of the measurements. It would also be interesting to correlate these area measurements with the clinical prognosis of patients after TMVI. Agreement between 3D TEE and CT measurements (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 254"},"PeriodicalIF":18.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multimodal imaging assessment of mitral valve area after transcatheter mitral valve implantation: A three-dimensional echocardiographic and CT scan study\",\"authors\":\"M. Jullien , M. Urena , D. Himbert , C. Nguyen , E. Brochet , P. Ou , B. Iung\",\"doi\":\"10.1016/j.acvdsp.2023.04.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>The assessment of mitral bioprosthetic area remains a technical challenge, and its calculation by the continuity equation using transthoracic echocardiography<span> (TTE) may be invalidated in several situations, especially after transcatheter mitral valve<span> implantation (TMVI). This study aims to develop a new technique to measure the mitral valve area after a TMVI using a multimodal three-dimensional echocardiographic and computed tomography (CT) approach.</span></span></p></div><div><h3>Method</h3><p><span>Among the patients hospitalized for TMVI at Bichat Hospital between June 2017 and February 2021, we selected 24 who had both a transesophageal echocardiography (TEE) and a </span>cardiac CT after TMVI and before discharge. We performed two area measurements by planimetry: the geometric orifice area (GOA) corresponding to the area delimited by the edges of the open valve leaflets after alignment in the plane of the proximal coaptation point of the bioprosthesis leaflets; and the smallest valve area (SVA) defined by the smallest measurable area of the open prosthesis, at the free edges of the leaflets.</p></div><div><h3>Results</h3><p>In our cohort, the GOA was 1.73<!--> <!-->±<!--> <!-->0.41<!--> <!-->cm<sup>2</sup> on 3D TEE and 1.75<!--> <!-->±<!--> <!-->0.42<!--> <!-->cm<sup>2</sup> on CT. The SVA was 1.40<!--> <!-->±<!--> <!-->0.31<!--> <!-->cm<sup>2</sup> on 3D TEE and 1.49<!--> <!-->±<!--> <!-->0.37<!--> <!-->cm<sup>2</sup> on CT. There was a good agreement between the two techniques for GOA and SVA (ICC<!--> <!-->><!--> <!-->0.6, <em>P</em> <!--><<!--> <!-->0.01) and a good correlation between the two measurements on 3D TEE as well as on CT (Pearson 0.88 and 0.91 respectively, <em>P</em> <!--><<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p><span>Our work suggests a new approach to multimodal assessment of prosthetic mitral valve area after TMVI, using 3D TEE and CT scan. Further studies are needed to complete our results, especially to confirm the feasibility and reproducibility of the measurements. It would also be interesting to correlate these area measurements with the clinical prognosis of patients after TMVI. Agreement between 3D TEE and CT measurements (</span><span>Fig. 1</span>).</p></div>\",\"PeriodicalId\":8140,\"journal\":{\"name\":\"Archives of Cardiovascular Diseases Supplements\",\"volume\":\"15 3\",\"pages\":\"Page 254\"},\"PeriodicalIF\":18.0000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Cardiovascular Diseases Supplements\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1878648023001611\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases Supplements","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878648023001611","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Multimodal imaging assessment of mitral valve area after transcatheter mitral valve implantation: A three-dimensional echocardiographic and CT scan study
Introduction
The assessment of mitral bioprosthetic area remains a technical challenge, and its calculation by the continuity equation using transthoracic echocardiography (TTE) may be invalidated in several situations, especially after transcatheter mitral valve implantation (TMVI). This study aims to develop a new technique to measure the mitral valve area after a TMVI using a multimodal three-dimensional echocardiographic and computed tomography (CT) approach.
Method
Among the patients hospitalized for TMVI at Bichat Hospital between June 2017 and February 2021, we selected 24 who had both a transesophageal echocardiography (TEE) and a cardiac CT after TMVI and before discharge. We performed two area measurements by planimetry: the geometric orifice area (GOA) corresponding to the area delimited by the edges of the open valve leaflets after alignment in the plane of the proximal coaptation point of the bioprosthesis leaflets; and the smallest valve area (SVA) defined by the smallest measurable area of the open prosthesis, at the free edges of the leaflets.
Results
In our cohort, the GOA was 1.73 ± 0.41 cm2 on 3D TEE and 1.75 ± 0.42 cm2 on CT. The SVA was 1.40 ± 0.31 cm2 on 3D TEE and 1.49 ± 0.37 cm2 on CT. There was a good agreement between the two techniques for GOA and SVA (ICC > 0.6, P < 0.01) and a good correlation between the two measurements on 3D TEE as well as on CT (Pearson 0.88 and 0.91 respectively, P < 0.001).
Conclusion
Our work suggests a new approach to multimodal assessment of prosthetic mitral valve area after TMVI, using 3D TEE and CT scan. Further studies are needed to complete our results, especially to confirm the feasibility and reproducibility of the measurements. It would also be interesting to correlate these area measurements with the clinical prognosis of patients after TMVI. Agreement between 3D TEE and CT measurements (Fig. 1).
期刊介绍：
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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