Transthoracic two-dimensional xPlane and three-dimensional echocardiographic analysis of the site of mitral valve prolapse.
This study sought to assess the value of two-dimensional (2D) transthoracic echocardiography (TTE), 2D xPlane imaging and three-dimensional (3D) TTE for the definition of the site and the extent of mitral valve (MV) prolapse. Fifty patients underwent transthoracic 2D, 2D xPlane and 3D echocardiography. With 2D xPlane a segmental analysis of the MV was performed, by making a lateral sweep across the MV coaptation line as seen in the parasternal short-axis view. Inter-observer agreement for specific scallop prolapse was for 2D xPlane excellent (97%, kappa = 0.94) and for 3D TTE moderate (85%, kappa = 0.67). The respective sensitivities of standard 2D TTE, 2D xPlane, and 3D TTE for the identification of the precise posterior scallop prolapse were for P1 92, 85, and 92%, for P2 96, 96, and 82%, and for P3 86, 81, and 71%. In total, 5 (8%) prolapsing MV scallops were missed by 2D TTE, 7 (12%) by 2D xPlane, and 12 (20%) by 3D TTE. The sensitivity of 3D TTE was significantly lower than standard 2D imaging (80% versus 93%, P < 0.05). The extent of P2 prolapse was under or overestimated in 5 patients with 2D xPlane and in 9 patients with 3D TTE. 2D xPlane imaging is an accurate, easy to use (compared to 3D TTE) and easy to interpret (compared to 2D and 3D TTE) imaging modality to study the site and the extent of MV prolapse.
Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. j.mcghie@erasmusmc.nl.
Jackie S
JS
McGhie
Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
Lotte
L
de Groot-de Laat
Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
Ben
B
Ren
Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
Wim
W
Vletter
Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
René
R
Frowijn
Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
Frans
F
Oei
Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
Marcel L
ML
Geleijnse
D000368:Aged; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index
Mitral valve; Three dimensional echocardiography; Two-dimensional xPlane echocardiography