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CLINICAL STUDIES

Three-dimensional color doppler: a clinical study in patients with mitral regurgitation

Raffaele De Simone, MD^*, Gerald Glombitza, PhD, Christian Friedrich Vahl, MD^*, J.örg Albers, MD^*, Hans Peter Meinzer, PhD and Siegfried Hagl, MD^*

^* University of Heidelberg, Heidelberg, Germany
Deutsches Krebsforschungszentrum, Heidelberg, Germany

Manuscript received August 20, 1998; revised manuscript received December 15, 1998, accepted January 14, 1999.

Reprint requests and correspondence: Raffaele De Simone, MD, University of Heidelberg, Abteilung für Herzchirurgie, Im Neuenheimer Feld, 120, D-69120 Heidelberg, Germany
r.de.simone{at}urz.uni-heidelberg.de

OBJECTIVES

The purpose of this study was to assess the clinical feasibility of three-dimensional (3D) reconstruction of color Doppler signals in patients with mitral regurgitation.

BACKGROUND

Two-dimensional (2D) color Doppler has limited value in visualizing and quantifying asymmetric mitral regurgitation. Clinical studies on 3D reconstruction of Doppler signals in original color coding have not yet been performed in patients. We have developed a new procedure for 3D reconstruction of color Doppler.

METHODS

We studied 58 patients by transesophageal 3D echocardiography. The jet area was assessed by planimetry and the jet volumes by 3D Doppler. The regurgitant fractions, the volumes, and the angiographic degree of mitral regurgitation were assessed in 28 patients with central jets and compared with those of 30 patients with eccentric jets.

RESULTS

In all patients, jet areas and jet volumes significantly correlated with the angiographic grading (r = 0.73 and r = 0.90), the regurgitant fraction (r = 0.68 and r = 0.80) and the regurgitant volume (r = 0.66 and r = 0.90). In patients with central jets, significant correlations were found between jet area and angiography (r = 0.86), regurgitant fraction (r = 0.64) and regurgitant volume (r = 0.78). No significant correlations were found between jet area and angiography (r = 0.53), regurgitant fraction (r = 0.52) and regurgitant volume (r = 0.53) in the group of patients with eccentric jets. In contrast, jet volumes significantly correlated with angiography (r = 0.90), regurgitant fraction (r = 0.75) and regurgitant volume (r = 0.88) in the group of patients with eccentric jets.

CONCLUSIONS

Three-dimensional Doppler revealed new images of the complex jet geometry. In addition, jet volumes, assessed by an automated voxel count, independent of manual planimetry or subjective estimation, showed that 3D Doppler is also capable of quantifying asymmetric jets.

Abbreviations and Acronyms   2D = two-dimensional   3D = three-dimensional

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