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- Title
Four-dimensional modelling of the mitral valve by real-time 3D transoesophageal echocardiography: proof of concept.
- Authors
Noack, Thilo; Mukherjee, Chirojit; Kiefer, Philipp; Emrich, Fabian; Vollroth, Marcel; Ionasec, Razvan Ioan; Voigt, Ingmar; Houle, Helene; Ender, Joerg; Misfeld, Martin; Mohr, Friedrich Wilhelm; Seeburger, Joerg
- Abstract
OBJECTIVES The complexity of the mitral valve (MV) anatomy and function is not yet fully understood. Assessing the dynamic movement and interaction of MV components to define MV physiology during the complete cardiac cycle remains a challenge. We herein describe a novel semi-automated 4D MV model. METHODS The model applies quantitative analysis of the MV over a complete cardiac cycle based on real-time 3D transoesophageal echocardiography (RT3DE) data. RT3DE data of MVs were acquired for 18 patients. The MV annulus and leaflets were semi-automatically reconstructed. Dimensions of the mitral annulus (anteroposterior and anterolateral–posteromedial diameter, annular circumference, annular area) and leaflets (MV orifice area, intercommissural distance) were acquired. Variability and reproducibility (intraclass correlation coefficient, ICC) for interobserver and intraobserver comparison were quantified at 4 time points during the cardiac cycle (mid-systole, end-systole, mid-diastole and end-diastole). RESULTS Mitral annular dimensions provided highly reliable and reproducible measurements throughout the cardiac cycle for interobserver (variability range, 0.5–1.5%; ICC range, 0.895–0.987) and intraobserver (variability range, 0.5–1.6%; ICC range, 0.827–0.980) comparison, respectively. MV leaflet parameters showed a high reliability in the diastolic phase (variability range, 0.6–9.1%; ICC range, 0.750–0.986), whereas MV leaflet dimensions showed a high variability and lower correlation in the systolic phase (variability range, 0.6–22.4%; ICC range, 0.446–0.915) compared with the diastolic phase. CONCLUSIONS This 4D model provides detailed morphological reconstruction as well as sophisticated quantification of the complex MV structure and dynamics throughout the cardiac cycle with a precision not yet described.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2015, Vol 20, Issue 2, p200
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivu357