Study on the mitral valve geometry of the healthy subjects assessed by real-time three-dimensional transthoracic echocardiography and real-time three-dimensional transesophageal echocardiography

Abstract

Objective To assess the correlation and agreement of the mitral valve geometry parameters obtained by real-time three-dimensional transthoracic echocardiography (RT-3D-TTE) and real-time three-dimensional transesophageal echocardiography (RT-3D-TEE). Methods RT-3D-TTE and RT-3D-TEE were performed on 29 healthy volunteers under conscious state and general anesthesia respectively. The mid-systole mitral valve parameters were analyzed by TomTec Imaging Systems. The repeatability test of the mitral valve parameters obtained by RT-3D-TTE was performed. The correlation and agreement of the mitral valve parameters obtained by RT-3D-TTE and RT-3D-TEE were assessed,and then the differences of mitral valve parameters between the two methods were compared. The study was approved by the Shanxi Dayi Hospital Ethics Committee (Approval no.YXLL-2015-040). Results ①The mitral valve parameters obtained by RT-3D-TTE showed excellent intra- and interobserver reproducibility,in intra-observer and inter-observer with ICC>0.8 for all the parameters,and the Bland-Altman plots displayed the average differences of anterior-posterior (AP),anterolateral-posteromedial (ALPM),annular circumference (AC),three-dimensional annular area (AA3D) for intra- and interobserver were 0.009±0.11,-0.008±0.10,-0.036±0.32,0.030±0.36 in intra-observer and -0.018±0.09,0.087±0.20,-0.037±0.44,-0.016±0.62 in inter-observers,respectively. ②There were close correlations (r=0.566-0.870,P 0.05). The rest of parameters including ALPM,sphericity (SPI),commissural diameter (CD),AC,AA3D,nonplanarity angle (NPA),tenting height (TH),maximum annular displacement (ADmax) and maximum annular displacement velocity (ADVmax) had significant differences (P<0.05). Conclusions The mitral valve parameters obtained by RT-3D-TTE are highly reproducible and similar to those obtained by RT-3D-TEE,and the two methods have close correlations and good agreement. Therefore,RT-3D-TTE has higher potential clinical application value in the evaluation of mitral valve geometry. Key words: Echocardiography,real-time three-dimensional; Mitral valve