title: Determination of regurgitant orifice area with the use of a new three-dimensional flow convergence geometric assumption in functional mitral regurgitation.
abstract: Geometry of the proximal isovelocity surface area (PISA) in functional mitral regurgitation (MR) is elongated, leading to underestimation of the effective regurgitant orifice (ERO) area. This underestimation could be corrected by a new hemiellipsoidal method. Thirty patients with functional MR were examined by real-time 3-dimensional (D) echocardiography. Two ERO areas were calculated from 3D measurements: ERO area by the hemispheric method and that by the new hemiellipsoidal method with our customized program. Each ERO area was compared with that by the 2D quantitative Doppler method. Color 3D images showed an elongated PISA geometry including 2 geometric types ("mountain" or "valley") in all patients with functional MR. Our hemiellipsoidal method could be adapted for all geometric types of PISA and underestimated ERO area by only 26%, whereas the underestimation by the hemispheric PISA method was 49%. The underestimation by the hemispheric PISA method can be significantly corrected by our hemiellipsoidal method.
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Saracino
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugioka
authors.forename: Hung
authors.initials: H
authors.lastname: Tran
authors.forename: Neil L
authors.initials: NL
authors.lastname: Greenberg
authors.forename: Nozomi
authors.initials: N
authors.lastname: Wada
authors.forename: Manatomo
authors.initials: M
authors.lastname: Toyono
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hozumi
authors.forename: James D
authors.initials: JD
authors.lastname: Thomas
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shiota
mesh_terms: D000465:Algorithms; D019412:Anatomy, Cross-Sectional / Q000379:methods; D003198:Computer Simulation; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging*; D008955:Models, Cardiovascular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity