Biplane transesophageal color Doppler echocardiography for assessment of mitral valve area with mitral inflow jet widths

Chunguang Chen, Birke Schneider, Dietmar Koschyk, Lianglong Chen, Tawhid Shuaib, Christian Hamm, Linda Gillam, Wolfram Kupper, Thomas Meinertz

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Biplane transesophageal color Doppler echocardiography can image the mitral valve orifice in two orthgonal views. If the maximal stenotic jet width through the mitral valve obtained with the vertical transducer represents the major axis, the stenotic jet width dissected by the horizontal transducer should be the minor axis of the mitral orifice. Thus the mitral valve area can be calculated assuming an oval shape of mitral orifice. Nineteen patients with mitral stenosis were investigated. Maximal mitral stenotic jet width (JW1) was searched on a vertical plane and the jet width from the orthogonal view (JW2) was obtained on a horizontal plane. Mitral valve areas from the color Doppler jet widths were calculated by: π·JW1/2·JW2/2 and compared with those derived from Gorlin's formula. Adequate quality of echocardiographic images could be obtained in all patients for transesophageal color Doppler jet width measurements or Doppler pressure half-time determinations and in 16 of 19 patients for transthoracic planimetery of the mitral orifice at the parasternal short axis. Mitral valve areas derived from biplane transesophageal color Doppler imaging (1.31±0.53 cm2) were not different from those calculated according to Gorlin's formula from the catheterization data (1.25±0.50 cm2), those determined by transthoracic echocardiographic planimetery (1.38±0.5 cm2), or those calculated from the Doppler pressure half-time method (1.32±0.41 cm2) (difference not significant by analysis of variance). There was a very strong correlation between transesophageal echocardiographic mitral valve areas and those derived from catheterization data (r=0.94; standard error of the estimate=0.13 cm2). A similar correaltion was obtained for the planimetric echocardiographic method (r=0.94; standard error of the estimate=0.14 cm2). A slightly less strong correlation was found between mitral valve areas derived from the Doppler pressure half-time method and those derived from Gorlin's formula (r=0.83; standard error of the estimate=0.24 cm2). The pressure half-time method accurately predicted the mitral valve area in most (15/19) patients, but it significantly (>0.4 cm2) overestimated mitral valve area in two patients with aortic regurgitation and underestimated (<0.4 cm2) mitral valve area in two patients with left ventricular hypertrophy. Determination of mitral valve area by color Doppler biplane transesophageal echocardiography is an alternative for accurate estimation of mitral valve area and may be most useful in intraoperative monitoring during surgical or balloon mitral commissurotomy or in the case of inadequate imaging quality of transthoracic echocardiography.

Original languageEnglish (US)
Pages (from-to)121-131
Number of pages11
JournalJournal of the American Society of Echocardiography
Volume8
Issue number2
DOIs
StatePublished - Jan 1 1995

Fingerprint

Doppler Color Echocardiography
Mitral Valve
Color
Pressure
Transducers
Catheterization
Intraoperative Monitoring
Aortic Valve Insufficiency
Mitral Valve Stenosis
Transesophageal Echocardiography
Left Ventricular Hypertrophy
Echocardiography

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Chen, Chunguang ; Schneider, Birke ; Koschyk, Dietmar ; Chen, Lianglong ; Shuaib, Tawhid ; Hamm, Christian ; Gillam, Linda ; Kupper, Wolfram ; Meinertz, Thomas. / Biplane transesophageal color Doppler echocardiography for assessment of mitral valve area with mitral inflow jet widths. In: Journal of the American Society of Echocardiography. 1995 ; Vol. 8, No. 2. pp. 121-131.
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Biplane transesophageal color Doppler echocardiography for assessment of mitral valve area with mitral inflow jet widths. / Chen, Chunguang; Schneider, Birke; Koschyk, Dietmar; Chen, Lianglong; Shuaib, Tawhid; Hamm, Christian; Gillam, Linda; Kupper, Wolfram; Meinertz, Thomas.

In: Journal of the American Society of Echocardiography, Vol. 8, No. 2, 01.01.1995, p. 121-131.

Research output: Contribution to journalArticle

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T1 - Biplane transesophageal color Doppler echocardiography for assessment of mitral valve area with mitral inflow jet widths

AU - Chen, Chunguang

AU - Schneider, Birke

AU - Koschyk, Dietmar

AU - Chen, Lianglong

AU - Shuaib, Tawhid

AU - Hamm, Christian

AU - Gillam, Linda

AU - Kupper, Wolfram

AU - Meinertz, Thomas

PY - 1995/1/1

Y1 - 1995/1/1

N2 - Biplane transesophageal color Doppler echocardiography can image the mitral valve orifice in two orthgonal views. If the maximal stenotic jet width through the mitral valve obtained with the vertical transducer represents the major axis, the stenotic jet width dissected by the horizontal transducer should be the minor axis of the mitral orifice. Thus the mitral valve area can be calculated assuming an oval shape of mitral orifice. Nineteen patients with mitral stenosis were investigated. Maximal mitral stenotic jet width (JW1) was searched on a vertical plane and the jet width from the orthogonal view (JW2) was obtained on a horizontal plane. Mitral valve areas from the color Doppler jet widths were calculated by: π·JW1/2·JW2/2 and compared with those derived from Gorlin's formula. Adequate quality of echocardiographic images could be obtained in all patients for transesophageal color Doppler jet width measurements or Doppler pressure half-time determinations and in 16 of 19 patients for transthoracic planimetery of the mitral orifice at the parasternal short axis. Mitral valve areas derived from biplane transesophageal color Doppler imaging (1.31±0.53 cm2) were not different from those calculated according to Gorlin's formula from the catheterization data (1.25±0.50 cm2), those determined by transthoracic echocardiographic planimetery (1.38±0.5 cm2), or those calculated from the Doppler pressure half-time method (1.32±0.41 cm2) (difference not significant by analysis of variance). There was a very strong correlation between transesophageal echocardiographic mitral valve areas and those derived from catheterization data (r=0.94; standard error of the estimate=0.13 cm2). A similar correaltion was obtained for the planimetric echocardiographic method (r=0.94; standard error of the estimate=0.14 cm2). A slightly less strong correlation was found between mitral valve areas derived from the Doppler pressure half-time method and those derived from Gorlin's formula (r=0.83; standard error of the estimate=0.24 cm2). The pressure half-time method accurately predicted the mitral valve area in most (15/19) patients, but it significantly (>0.4 cm2) overestimated mitral valve area in two patients with aortic regurgitation and underestimated (<0.4 cm2) mitral valve area in two patients with left ventricular hypertrophy. Determination of mitral valve area by color Doppler biplane transesophageal echocardiography is an alternative for accurate estimation of mitral valve area and may be most useful in intraoperative monitoring during surgical or balloon mitral commissurotomy or in the case of inadequate imaging quality of transthoracic echocardiography.

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