Utility of Three-Dimensional Transesophageal Echocardiography for Mitral Annular Sizing in Transcatheter Mitral Valve Replacement Procedures: A Cardiac Computed Tomographic Comparative Study.

Autor:	Coisne A; Department of Clinical Physiology and Echocardiography - Heart Valve Center, CHU Lille, Lille, France; Université de Lille, U1011 - EGID, Lille, France; Inserm, U1011, Lille, France; Institut Pasteur de Lille, Lille, France. Electronic address: augustin.coisne@chru-lille.fr., Pontana F; Université de Lille, U1011 - EGID, Lille, France; Inserm, U1011, Lille, France; Institut Pasteur de Lille, Lille, France; Department of Cardiovascular Radiology, CHU Lille, Lille, France., Aghezzaf S; Department of Clinical Physiology and Echocardiography - Heart Valve Center, CHU Lille, Lille, France., Mouton S; Department of Clinical Physiology and Echocardiography - Heart Valve Center, CHU Lille, Lille, France., Ridon H; Department of Clinical Physiology and Echocardiography - Heart Valve Center, CHU Lille, Lille, France., Richardson M; Department of Clinical Physiology and Echocardiography - Heart Valve Center, CHU Lille, Lille, France., Polge AS; Department of Clinical Physiology and Echocardiography - Heart Valve Center, CHU Lille, Lille, France., Longère B; Department of Cardiovascular Radiology, CHU Lille, Lille, France., Silvestri V; Department of Cardiovascular Radiology, CHU Lille, Lille, France., Pagniez J; Department of Cardiovascular Radiology, CHU Lille, Lille, France., Bical A; Department of Cardiovascular Surgery, CHU Lille, Lille, France., Rousse N; Department of Cardiovascular Surgery, CHU Lille, Lille, France., Overtchouk P; Department of Cardiovascular Surgery, CHU Lille, Lille, France., Granada JF; Cardiovascular Research Foundation, Columbia University Medical Center, New York, New York., Hahn RT; Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York., Modine T; Department of Cardiovascular Surgery, CHU Lille, Lille, France., Montaigne D; Department of Clinical Physiology and Echocardiography - Heart Valve Center, CHU Lille, Lille, France; Université de Lille, U1011 - EGID, Lille, France; Inserm, U1011, Lille, France; Institut Pasteur de Lille, Lille, France.
Jazyk:	angličtina
Zdroj:	Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography [J Am Soc Echocardiogr] 2020 Oct; Vol. 33 (10), pp. 1245-1252.e2. Date of Electronic Publication: 2020 Jul 25.
DOI:	10.1016/j.echo.2020.04.030
Abstrakt:	Background: Three-dimensional (3D) transesophageal echocardiographic (TEE) imaging is frequently used as an initial screening tool in the evaluation of patients who are candidates for transcatheter mitral valve replacement (TMVR). However, little is known about the imaging correlation with the gold standard, computed tomographic (CT) imaging. The aims of this study were to test the quantitative differences between these two modalities and to determine the best 3D TEE parameters for TMVR screening. Methods: Fifty-seven patients referred to the heart valve clinic for TMVR with prostheses specifically designed for the mitral valve were included. Mitral annular (MA) analyses were performed using commercially available software on 3D TEE and CT imaging. Results: Three-dimensional TEE imaging was feasible in 52 patients (91%). Although 3D TEE measurements were slightly lower than those obtained on CT imaging, measurements of both projected MA area and perimeter showed excellent correlations, with small differences between the two modalities (r = 0.88 and r = 0.92, respectively, P < .0001). Correlations were significant but lower for MA diameters (r = 0.68-0.72, P < .0001) and mitroaortic angle (r = 0.53, P = .0001). Receiver operating characteristic curve analyses showed that 3D TEE imaging had a good ability to predict TMVR screening success, defined by constructors on the basis of CT measurements, with ranges of 12.9 to 15 cm 2 for MA area (area under the curve [AUC] = 0.88-0.91, P < .0001), 128 to 139 mm for MA perimeter (AUC = 0.85-0.91, P < .0001), 35 to 39 mm for anteroposterior diameter (AUC = 0.79-0.84, P < .0001), and 37 to 42 mm for posteromedial-anterolateral diameter (AUC = 0.81-0.89, P < .0001). Conclusions: Three-dimensional TEE measurements of MA dimensions display strong correlations with CT measurements in patients undergoing TMVR screening. Three-dimensional TEE imaging should be proposed as a reasonable alternative to CT imaging in this vulnerable population. (Copyright © 2020 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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