3-Dimensional Echocardiographic Prediction of Left Ventricular Outflow Tract Area Prior to Transcatheter Mitral Valve Replacement.
JACC Cardiovasc Imaging
; 17(10): 1168-1178, 2024 Oct.
Article
em En
| MEDLINE
| ID: mdl-39066744
ABSTRACT
BACKGROUND:
New postprocessing software facilitates 3-dimensional (3D) echocardiographic determination of mitral annular (MA) and neo-left ventricular outflow tract (neo-LVOT) dimensions in patients undergoing transcatheter mitral valve replacement (TMVR).OBJECTIVES:
This study aims to test the accuracy of 3D echocardiographic analysis as compared to baseline computed tomography (CT).METHODS:
A total of 105 consecutive patients who underwent TMVR at 2 tertiary care centers between October 2017 and May 2023 were retrospectively included. A virtual valve was projected in both baseline CT and 3D transesophageal echocardiography (TEE) using dedicated software. MA dimensions were measured in baseline images and neo-LVOT dimensions were measured in baseline and postprocedural images. All measurements were compared to baseline CT as a reference. The predicted neo-LVOT area was correlated with postprocedural peak LVOT gradients.RESULTS:
There was no significant bias in baseline neo-LVOT prediction between both imaging modalities. TEE significantly underestimated MA area, perimeter, and medial-lateral dimension compared to CT. Both modalities significantly underestimated the actual neo-LVOT area (mean bias pre/post TEE 25.6 mm2, limit of agreement -92.2 mm2 to 143.3 mm2; P < 0.001; mean bias pre/post CT 28.3 mm2, limit of agreement -65.8 mm2 to 122.4 mm2; P = 0.046), driven by neo-LVOT underestimation in the group treated with dedicated mitral valve bioprosthesis. Both CT- and TEE-predicted-neo-LVOT areas exhibited an inverse correlation with postprocedural LVOT gradients (r2 = 0.481; P < 0.001 for TEE and r2 = 0.401; P < 0.001 for CT).CONCLUSIONS:
TEE-derived analysis provides comparable results with CT-derived metrics in predicting the neo-LVOT area and peak gradient after TMVR.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cateterismo Cardíaco
/
Valor Preditivo dos Testes
/
Função Ventricular Esquerda
/
Ecocardiografia Transesofagiana
/
Ecocardiografia Tridimensional
/
Implante de Prótese de Valva Cardíaca
/
Valva Mitral
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article