Quantification of mitral valve apparatus by three-dimensional transesophageal echocardiography: in vitro validation study comparing two different analysis systems.
BACKGROUND
Two commercial software systems have become available for quantitation of mitral leaflet and annulus geometry based on three-dimensional (3D) transesophageal echocardiographic (3DTEE) images. The aim of this study is to investigate the accuracy and compatibility of the three-dimensional (3D) measurements by Real View(®) and MVQ(®).


METHODS
3DTEE images were obtained from phantom models with saddle-shaped annulus of mitral valve prolapse and mitral valve tenting. From reconstructed 3D data, prolapse and tenting volume were calculated by both Real View(®) and MVQ(®) and compared with the actual volume.


RESULTS
The volume of the phantom models with saddle-shaped annulus measured by Real View(®) (tenting r = 0.99, prolapse r = 0.99) and MVQ(®) (tenting r = 0.99, prolapse r = 0.99) showed good agreement with the actual volume. However, significant difference between Real View(®) and MVQ(®) was observed in the result of quantification (tenting 2.27 ± 1.5 ml versus 2.53 ± 1.6 ml, prolapse 2.55 ± 1.7 ml versus 2.31 ± 1.6 ml, both P < 0.05).


CONCLUSIONS
Although the 2 commercially available systems allow accurate quantitative measurements of the 3D volume, discrepancy in the quantified value as a result of differences in the estimation of annular level is observed. Therefore, we should take into account the characteristics of each software when interpreting analytical results.
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. ksaito@med.kawasaki-m.ac.jp.
Ken
K
Saito
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Hiroyuki
H
Okura
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Nozomi
N
Watanabe
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Koichiro
K
Imai
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Tomoko
T
Tamada
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Terumasa
T
Koyama
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Akihiro
A
Hayashida
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Yoji
Y
Neishi
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Takahiro
T
Kawamoto
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Kiyoshi
K
Yoshida
Mitral annular geometry; Mitral valve prolapse; Mitral valve tenting; Quantitative software system; Three-dimensional transesophageal echocardiography