title: Influence of different echocardiographic imaging modes on the assessment of anterior mitral leaflet thickness.
abstract: OBJECTIVE
  The study aim was to compare fundamental imaging (FI) measurements with harmonic imaging (HI) measurements and surgical measurements (SM) in the assessment of mitral anterior leaflet thickness.
  
  
  METHODS
  Forty-three patients scheduled to undergo mitral valve replacement were included. Before surgery, routine echocardiography was performed in all patients using an instrument fitted with a 2.5 MHz broadband transducer. The anterior mitral leaflet was measured with different echocardiographic imaging modalities, and also surgically. During FI, the transducer transmission frequencies were 2.5 MHz and 2 MHz, while transmission frequencies of 1.7 MHz and 1.5 MHz were used during HI. Surgical measurements were taken immediately after surgery from a mitral valve specimen that was removed intact.
  
  
  RESULTS
  Mitral anterior leaflet thickness measurements derived from FI at 2 MHz transmission frequency (3.8 +/- 1.1 mm, p = 0.020), HI at 1.7 MHz (4.4 +/- 1.2 mm, p < 0.001), and HI at 1.5 MHz (4.5 +/- 1.2 mm, p < 0.001) were significantly larger than those made surgically (3.3 +/- 0.6 mm). However, no significant differences were seen between thickness measurements derived from FI at 2.5 MHz transmission frequency and SM (3.7 +/- 1 mm versus 3.3 +/- 0.6 mm, p = 0.063). Mitral anterior leaflet thickness was greater with HI than with FI (1.7 MHz versus 2.5 MHz, p < 0.001; 1.7 MHz versus 2 MHz, p < 0.005; 1.5 MHz versus 2.5 MHz, p < 0.001; 1.5 MHz versus 2 MHz; p < 0.002). The closest measurement to SM was that obtained at a transmission frequency of 2.5 MHz (mean difference 0.3 +/- 0.6 mm; SEE 0.1 mm).
  
  
  CONCLUSIONS
  Mitral anterior leaflet thickness measurements made with HI appear to be greater than those made with either FI or SM.
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. sevket5@yahoo.com
authors.forename: Sevket
authors.initials: S
authors.lastname: Gorgulu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
authors.forename: Bayram
authors.initials: B
authors.lastname: Bagirtan
authors.forename: Nevzat
authors.initials: N
authors.lastname: Uslu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ates
authors.forename: Tuna
authors.initials: T
authors.lastname: Tezel
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography