title: 3D color-Doppler echocardiography and chronic aortic regurgitation: a novel approach for severity assessment.
abstract: BACKGROUND
  3D echocardiography provides a complete evaluation of the aortic valve and adjacent structures and it improves the assessment of this cardiac region. Three-dimensional color-Doppler echocardiography (3DCDE) evaluation might improve the measurements of the functional regurgitant orifice in patients with Chronic Aortic Regurgitation (CAR).
  
  
  OBJECTIVE
  Our aim was to compare the accuracy of current echo-Doppler methods and 3DCDE for the assessment of CAR severity. The reference method used in this work was the CAR severity determined by means of cardiac magnetic resonance (CMR) METHODS: Thirty-two consecutive patients with an established diagnosis of CAR recruited in our institution comprised our study group. CAR severity was determined by conventional Echo-Doppler methods and by 3DCDE and their results were compared with those obtained by means of CMR.
  
  
  RESULTS
  Mean age was 63.0 ± 13.5 years. Twenty-two patients (68.8%) were men. Compared with the traditional echo-Doppler methods, 3DCDE evaluation had the best linear association with CMR results (3D vena contracta cross sectional area method: r = 0.88; r square = 0.77; p < 0.001. 3D vena contracta cross sectional area/left ventricular outflow tract cross sectional area method: r = 0.87; r square = 0.75; p < 0.001). The ROC analysis showed an excellent area under curve for detection of severe CAR (3D vena contracta cross sectional area method = 0.97; 3D vena contracta cross sectional area/left ventricular outflow tract cross sectional area method = 0.98). Inter- and intra-observer variability for the 3DCDE evaluation was good (ICC = 0.89 and ICC = 0.91 for inter and intra observer variability respectively).
  
  
  CONCLUSIONS
  3DCDE is an accurate and highly reproducible diagnostic tool for estimating CAR severity. Compared with the traditional echo-Doppler methods, 3DCDE has the best agreement with the CMR determined CAR severity. Thus, 3DCDE is a diagnostic method that may improve the therapeutic management of patients with CAR.
authors.affiliation: Unidad de Imagen Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. leopisla@hotmail.com
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Perez de Isla
authors.forename: Jose
authors.initials: J
authors.lastname: Zamorano
authors.forename: Covadonga
authors.initials: C
authors.lastname: Fernandez-Golfin
authors.forename: Sara
authors.initials: S
authors.lastname: Ciocarelli
authors.forename: Cecilia
authors.initials: C
authors.lastname: Corros
authors.forename: Tibisai
authors.initials: T
authors.lastname: Sanchez
authors.forename: Joaquín
authors.initials: J
authors.lastname: Ferreirós
authors.forename: Pedro
authors.initials: P
authors.lastname: Marcos-Alberca
authors.forename: Carlos
authors.initials: C
authors.lastname: Almeria
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Rodrigo
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology; D018618:Echocardiography, Doppler, Color / Q000379:methods* / Q000592:standards; D019560:Echocardiography, Three-Dimensional / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index