Diagnostic value of mitral regurgitant jet volume in the assessment of mitral regurgitation severity by general imaging
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ORIGINAL PAPER
Diagnostic value of mitral regurgitant jet volume in the assessment of mitral regurgitation severity by general imaging three‑dimensional quantification Wugang Wang1 · Yong Jiang2 · Junfang Li1 · Kun Gong1 · Liang Zhao1 · Guozhang Tang1 · Yuanyuan Meng1 · Zhibin Wang1 Received: 10 February 2020 / Accepted: 7 June 2020 © Springer Nature B.V. 2020
Abstract Accurate quantification of mitral regurgitation (MR) severity is critical for appropriate clinical decision making regarding surgical intervention. General imaging three-dimensional quantification (GI3DQ) method allows for direct measurement of mitral regurgitant jet volume (MRJvol) with the help of three-dimensional (3D) color flow Doppler imaging. The aim of this study was to evaluate diagnostic value of MRJvol by GI3DQ for MR grading severity, using the guideline recommended integrated approach as a reference. The study included ninety-seven patients with varying degree of MR, and all MR cases were divided into central MR group (n = 44) and eccentric MR group (n = 53). The MRJvol was measured by GI3DQ. The severity of MR was graded on the basis of recommended integrated approach as mild, moderate, or severe. As assessed by receiver operating characteristic analysis, MRJvol by GI3DQ at a cutoff value of 43.4 ml yielded 76.9% of sensitivity and 86.9% of specificity to differentiate moderate from severe MR in all cases, a cutoff value of 47.5 ml yielded 98.9% of sensitivity and 94.4% of specificity to differentiate moderate from severe MR in central MR, and a cutoff value of 40.7 ml yielded 80.0% of sensitivity and 78.6% of specificity to differentiate moderate from severe MR in eccentric MR. MRJvol measured by GI3DQ could assess MR severity, especially in central MR group, which has higher sensitivity and specificity to differentiate moderate from severe MR. Keywords General imaging three-dimensional quantification · Mitral regurgitation · Mitral regurgitant jet volume · Echocardiography
Introduction Mitral regurgitation (MR) is a common valvular disease and increasingly prevalent with the aging of population [1], which ultimately progresses to irreversible heart failure with high morbidity and mortality if untreated [2, 3]. Therefore, accurate quantification of MR severity is critical for appropriate clinical decision making regarding surgical intervention [4, 5]. Echocardiography is the primary method * Zhibin Wang [email protected] 1
Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong, China
Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing 100037, China
2
of non-invasive assessment of MR severity, but its accuracy is still a controversial issue [6, 7]. The American Society of Echocardiography (ASE) proposes an integrated approach for grading the MR severity that includes two-dimensional (2D) quantitative, semiquantitative, and qualitative parameters, which ar
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