title: Real-Time 3-Dimensional Echocardiographic Assessment of Effective Regurgitant Orifice Area in Dogs With Myxomatous Mitral Valve Disease.
abstract: BACKGROUND
  Effective regurgitant orifice area (EROA), calculated from the vena contracta width (VCW) as the narrowest portion of the proximal regurgitant jet, might be used to estimate severity of mitral regurgitation. However, this simplified assumption only holds when the EROA is circular, which might not be true in dogs with myxomatous mitral valve disease (MMVD).
  
  
  OBJECTIVE
  Effective regurgitant orifice area in dogs with MMVD is noncircular, and using color Doppler real-time 3-dimensional (RT3D) echocardiography, measured EROA in the en face view will be significantly different from calculated EROA.
  
  
  METHODS
  Hundred and fifty-eight privately owned dogs with naturally occurring MMVD.
  
  
  METHODS
  Prospective observational study comparing en face view of EROA with calculated EROA using VCW in 4-chamber (4Ch) and 2-chamber (2Ch) view only or combined 4Ch and 2Ch views using RT3D echocardiography.
  
  
  RESULTS
  The calculated EROA using the 2Ch view showed a systematic underestimation of 17% compared with the measured en face EROA corrected for body surface area. The calculated EROA using 4Ch and 4Ch + 2Ch views showed less agreement with the en face EROA, and the difference between methods increased with increasing EROA. The difference between calculated and measured EROA showed a systematic underestimation of the calculated EROA by 36% (4Ch) and 33% (4Ch + 2Ch), respectively, compared to measured en face EROA.
  
  
  CONCLUSIONS
  When replacing measured EROA with calculated EROA using VCW measurements, the 2Ch view is preferred in dogs with MMVD.
authors.affiliation: Anicura Albano Animal Hospital, Danderyd, Sweden.|Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Tidholm
authors.affiliation: Anicura Albano Animal Hospital, Danderyd, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Bodegård-Westling
authors.affiliation: Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Höglund
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Häggström
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Ljungvall
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000000981:diagnostic imaging*; D004285:Dogs; D019560:Echocardiography, Three-Dimensional / Q000662:veterinary; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000662:veterinary*; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000662:veterinary
keywords: Color flow Doppler; Mitral regurgitation; Regurgitant jet area; Vena contracta