Comparison of three-dimensional transesophageal echocardiography versus two-dimensional transthoracic echocardiography-a feasibility in patients with aortic stenosis
AWAD MOHAMMAD, Amane |
Recenzentas / Reviewer | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Aim of the research: To assess feasibility of aortic root measurements using three-dimensional echocardiographic data sets in patients with aortic stenosis and compare to conventional methods. Objectives: To compare differences in aortic root measurements using two-dimensional transthoracic echocardiography and three-dimensional transesophageal echocardiography. Secondly, to evaluate the relationship between additional measurements of the aortic sinuses and conventional linear measurements. Thirdly, determine which imaging modality is superior: 2D TTE or 3D TEE. Methodology: 29 patients with normal aortic valve anatomy, were included into this study. QLAB program has been used to assess the aortic root dimensions. 2D TTE aortic root dimensions (left ventricular outflow tract, aortic annulus, sinuses and sinutubular junction diameters) were taken from patient case histories echocardiographic protocols. The area of outflow tract, aortic annulus and sinutubular junction was calculated using formula: Area (cm2) =D2 x0.785. The data was collected and analysed on the SPSS computer program. Comparison of the two different image modalities (3D TEE vs 2D TTE) of the same structure will tell us if there is a difference between the two image modalities. Results: We observed that: aall linear measurement was different significantly, except anteroposterior aortic annulus diameter (p=0.83). All sinus diameters in 3D TEE images were significantly lower to conventional sinus measurement from 2D TTE image (3.490.46cm, p<0.001). Rrelationship between 2D TTE measurement of aortic sinuses and all measurements of sinuses from 3D TEE, showed good and statistically significant correlation between both methods. Bland-Altman analysis for + 2SD whowed that LVOT and AA shows statistically significant difference between 2D TTE and 3D TEE modalities where 2D TTE underestimates the values. However, for STJ, 2D TTE measurements showed overestimation of the value. Conclusions: Aortic root anatomy evaluation from 3D TEE is feasible in most of cases. 3D TEE image analysis shows higher values of LVOT, higher AA area, but lower values of STJ measurements. Additional linear measurements of aortic sinuses show lower values than standard linear diameter obtained from two-dimensional imaging. Two-dimensional echocardiography underestimates left ventricular outflow tract and aortic annulus area measurement against three-dimensional echocardiography, while overestimates in sinutubular junction measurement.
Tyrimo tikslas: Įvertinti trimatės echokardiografijos tinkamumą aortos šaknies matavimams pacientams su aortos vožtuvo stenoze ir palyginti su įprastais echokardiografiniais matavimais. Uždaviniai: 1.Palyginti aortos šaknies matavimus tarp trimatės perstemplinės echokardiografijos ir dvimatės perkrūtininės echokardiografijos. 2. Įvertinti papildomų aortos sinusų matavimų ryšį su įprastais linijiniais matavimais. 3. Įvertinti echokardiografinio tyrimo pranašumą tarp trimatės perstemplinės ir dvimatės perkrūtininės echokardiografijos vertinant aortos šaknies matavimus.
Išvados: Kairiojo skilvelio nutekamojo trakto ir aortos vožtuvo žiedo matavimų vertės mažesnės įvertinus įprasta perkrūtinine echokardiografija palyginti su trimate perstempline echokardiografija, o sinotubulinės jungties dydžiai įprstiniais metodais pervertinami.