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Objective To quantitatively analysis the aortic valve leaf anatomical characteristics in aortic regurgitation(AR) patients by real-time three-dimensional transesophageal echocardiography (RT-3D-TEE),and screening the parameters which significantly affect AR to further reveal the mechanism of AR.Methods 32 patients with AR were enrolled as AR group and 20 cases of non-AR people were involved as control group.RT-3D-TEE was using to collect images in two groups and offline analysis was performed.4 sets of parameters of the aortic valves(left coronary valve,right coronary valve,and non-coronary valve):leaflet edge length(LL,RL,NL),leaflet height (LH,RH,N H),leaflet length/height ratio (LRa,RRa,NRa),leaflet tip plane distance(LTH,RTH,NTH) were acquired.Parameters of two groups were compared,and the parameters were incorporated into the logistic regression model,then the ROC curves were obtained.Results ①Compared with the control group,LL,RL,NL,RH,LRa,NRa,RRa in AR group increased (P ＜ 0.05),while the rest parameters had no statistical differences (P ＞0.05).②Multivariable logistic regression model gradually screening of the significant factors influencing the reflux,and as a result RL and RTH had significant influence on AR,P values were 0.001,0.011.③The ROC curve analysis showed that the area of RL or RTH curve were both greater than 0.5,which were 0.811 and 0.605 respectively.Conclusions The free edge length and free edge length/height ratio have changed unbalanced.Furthermore,right coronary valve parameters changed significantly,and this might be one of the possible mechanism of AR.
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Objective To assess the left ventricular(LV) volumes and function acquired by realtime (RT) three-dimensional echocardiography (3DE) versus magnetic resonance imaging (MRI) in elderly patients.Methods A total of 31 patients aged≥60 years [mean (72.1±6.6) years] with various cardiovascular diseases were evaluated by MRI versus RT-3DE on the same day.RT-3DE was performed with a Philips iE-33 echocardiographic system,and LV volumes and function were analyzed with the assistance of TomTec software.The results of LV volumes and function obtained by manual tracing were compared with Signa 1.5-T MRI data.The acquisition of RT-3DE datasets was feasible in all 31 patients.Results The average MRI-detected LV end diastolic volume (LVEDV) was (139.1 ±40.8) ml,LV end systolic volume (LVESV) was (77.8±41.7)ml,LV ejection fraction (LVEF) was (47.9±14.3)％.The average RT-3DE-detected LVEDV was (119.5±37.7) ml,LVESV was (65.5±36.1) ml,LVEF was (47.9± 14.3)％.Compared with MRI values,LVEDV was underestimated by RT-3DE (P＜0.01,r=0.79,y=0.73 x+17.8,SEE=23.5 ml),with a mean difference of (-19.6±25.6)ml; LVESV was also underestimated by RT-3DE (P＜0.01,r=0.89,y =0.77 x+ 5.6,SEE=16.8 ml),with a mean difference of(-12.3± 19.1)ml.Ejection fraction determined by MRI was the same as that by RT-3DE (P＞0.05,r=0.91,y=0.75 x+ 13,SEE=5.61％),with a mean difference of (1.1±7.4) ％.There was good interobserver reproducibility in LV volume detected by RT-3D.Conclusions Compared with MRI,RT-3DE has more accuracy and repeatability in assessment of LV volume and ejection fraction in elderly patients.
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Objective To assess the accuracy and repeatability of real-time three-dimensional eehoeardiography (RT-3DE) for the measurements of left ventricular (LV) mass in elderly patients compared with magnetic resonance imaging (MRI).Methods A total of 31 patients (26 men) aged ≥60 years (72.1±6.6) years with various cardiovascular diseases were evaluated by MRI and RT- 3DE on the same day.RT-3DE was performed with a Philips iE-33 echocardiographic system, and LV mass was analyzed with the assistance of TomTec software.The results of LV mass obtained by manual tracing were compared with Signa 1.5-T MRI data.The acquisition of RT-3DE datasets was feasible in all 31 patients.Results A good correlation was observed between RT-3DE data with manual border detection and MRI for LV mass (r=0.869, y=0.943 x+11.69, SE= 19.09 g, P< 0.01), with a mean difference of (4.7±37.7)g.The average LV mass was (123.9±35.0)g (74.4-208.1 g) evaluated by MRI, and was (128.6±37.9)g (67.0-222.9 g) evaluated by RT-3DE.There was good inter- or intra-observer correlation between RT-3DE by two sonographers for LV mass.Conclusions The assessment of LV mass from RT-3DE data is feasible in elderly patients.The mass can be determined with high accuracy and low interobserver variability in elderly patients with adequate eehocardiographic image quality.