Three‐dimensional transesophageal echocardiography vs cardiac magnetic resonance in the assessment of planimetric mitral valve area in rheumatic mitral stenosis

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 35; no. 10; pp. 1621 - 1625
• Main Authors: Uygur, Begum, Celik, Omer, Ustabasioglu, Fethi Emre, Akinci, Okan, Erturk, Mehmet
• Format: Journal Article
• Language: English
• Published: United States 01.10.2018
• Subjects: Adult; cardiac magnetic resonance imaging; Echocardiography, Three-Dimensional - methods; Echocardiography, Transesophageal - methods; Female; Humans; Magnetic Resonance Imaging - methods; Male; mitral stenosis; Mitral Valve - diagnostic imaging; mitral valve area; Mitral Valve Stenosis - diagnostic imaging; Mitral Valve Stenosis - etiology; Reproducibility of Results; Retrospective Studies; Rheumatic Heart Disease - complications; Severity of Illness Index; three‐dimensional transesophageal echocardiography; cardiac magnetic resonance imaging; mitral valve area; mitral stenosis; three-dimensional transesophageal echocardiography
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.14096

Aim Rheumatic heart disease is a common cause of valvular disease, especially in developing countries. Echocardiography is the gold standard investigation modality for cardiac valves. In rheumatic mitral stenosis (MS), three‐dimensional transesophageal echocardiography (3D TEE) provides better alignment of the image plane at the mitral tips and more accurate and reproducible planimetric measurement of mitral valve area (MVA). Cardiac magnetic resonance (CMR) is a new method that provides evaluation of cardiac anatomy and function noninvasively. Previous studies showed strong correlation between planimetric MVA measured by two‐dimensional transthoracic echocardiography and CMR. We aimed to compare the planimetric MVAs assessed by 3D TEE and CMR in rheumatic MS patients. To best of our knowledge, this is the first study that compares 3D TEE and CMR for the assessment of the planimetric MVA in rheumatic MS. Methods We retrospectively evaluated 28 rheumatic MS patients who underwent 3D TEE and ECG‐gated CMR. 3D TEE planimetric MVAs were measured manually by multiplanar reconstruction (MPR) method and CMR planimetric MVAs were measured manually on short‐axis cine images. Then, 3D TEE and CMR measurements were compared. Results A total of 28 patients’ (mean age 44 ± 12, 82.1% female) planimetric 3D TEE MVAs (1.00 ± 0.20 cm2) and CMR MVAs (1.04 ± 0.17 cm2) were found to be highly correlated (P < 0.0001, r: 0.744) with Pearson correlation analysis. Bland–Altman analysis showed strong agreement between two techniques. Conclusion For the diagnosis and the follow‐up of rheumatic MS, planimetric CMR MVA is an alternative noninvasive method which highly correlates with planimetric 3D TEE MVA.