title: Fully automated software for mitral annulus evaluation in chronic mitral regurgitation by 3-dimensional transesophageal echocardiography.
abstract: Three-dimensional (3D) transesophageal echocardiography (TEE) is the gold standard for mitral valve (MV) anatomic and functional evaluation. Currently, dedicated MV analysis software has limitations for its use in clinical practice. Thus, we tested here a complete and reproducible evaluation of a new fully automatic software to characterize MV anatomy in different forms of mitral regurgitation (MR) by 3D TEE.Sixty patients were included: 45 with more than moderate MR (28 organic MR [OMR] and 17 functional MR [FMR]) and 15 controls. All patients underwent TEE. 3D MV images obtained using 3D zoom were imported into the new software for automatic analysis. Different MV parameters were obtained and compared. Anatomic and dynamic differences between FMR and OMR were detected. A significant increase in systolic (859.75 vs 801.83 vs 607.78 mm; P = 0.002) and diastolic (1040.60 vs. 1217.83 and 859.74 mm; P < 0.001) annular sizes was observed in both OMR and FMR compared to that in controls. FMR had a reduced mitral annular contraction compared to degenerative cases of OMR and to controls (17.14% vs 32.78% and 29.89%; P = 0.007). Good reproducibility was demonstrated along with a short analysis time (mean 4.30 minutes).Annular characteristics and dynamics are abnormal in both FMR and OMR. Full 3D software analysis automatically calculates several significant parameters that provide a correct and complete assessment of anatomy and dynamic mitral annulus geometry and displacement in the 3D space. This analysis allows a better characterization of MR pathophysiology and could be useful in designing new devices for MR repair or replacement.
authors.affiliation: Cardiology Department, Ramón y Cajal University Hospital, Madrid, Spain Cardiovascular Institute, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Aquila
authors.forename: Covadonga
authors.initials: C
authors.lastname: Fernández-Golfín
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Rincon
authors.forename: Ariana
authors.initials: A
authors.lastname: González
authors.forename: Ana
authors.initials: A
authors.lastname: García Martín
authors.forename: Rocio
authors.initials: R
authors.lastname: Hinojar
authors.forename: Jose Julio
authors.initials: JJ
authors.lastname: Jimenez Nacher
authors.forename: Ciro
authors.initials: C
authors.lastname: Indolfi
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Zamorano
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001331:Automation / Q000295:instrumentation* / Q000379:methods; D016022:Case-Control Studies; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012984:Software; D013030:Spain