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使用半自动四维分析评估重度二尖瓣反流患者的D形二尖瓣环:对经导管干预的意义

Assessment of D-Shaped Annulus of Mitral Valve in Patients with Severe MR Using Semi-Automated 4-Dimensional Analysis: Implications for Transcatheter Interventions.

作者信息

Vo N Mai, van Wijngaarden Suzanne E, Marsan Nina Ajmone, Bax Jeroen J, Delgado Victoria

机构信息

Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands.

出版信息

J Cardiovasc Dev Dis. 2020 Nov 1;7(4):48. doi: 10.3390/jcdd7040048.

Abstract

The development of transcatheter mitral valve replacement therapies requires accurate post-processing analysis tools to provide D-shaped mitral annulus dimensions from 3-dimensional (3D) data. The agreement between two semi-automated, software packages to process 3D transesophageal echocardiography (TEE) data for the measurement of the mitral valve annulus dimensions was evaluated. 3DTEE data of patients with moderate-severe mitral regurgitation (MR) were postprocessed with semi-automated, vendor-independent (VI) software and vendor-specific (VS) software. Both post-processing software provided key measurements for the selection of transcatheter valve prosthesis size: annulus area, annulus circumference and the septal-to-lateral distance of the annulus. The intertrigonal distance was provided only by the VS software. The inter- and intra-observer agreements were assessed with Bland-Altman analysis. Of 105 patients (63.8 ± 11 years, 66% male) with MR, 28 had secondary MR, 45 fibroelastic deficiency, and 32 Barlow's disease. Using VS software, the dimensions for the overall population were 16.1 ± 4.6 cm for annulus area, for circumference 14.4 ± 1.9 cm, intertrigonal distance 3.4 ± 0.5 cm and septal-to-lateral distance 3.8 ± 0.6 cm. Similar dimensions were obtained using VI software: 15.7 ± 4.6 cm for annulus area, 14.5 ± 2.0 cm for circumference, and 4.1 ± 0.6 cm for septal-to-lateral distance. The inter- and intra-observer agreement for both software programs was excellent. In conclusion, current post-processing software programs for 3DTEE data of the mitral valve annulus provide good reproducibility of key measurements to select the transcatheter prosthesis size.

摘要

经导管二尖瓣置换疗法的发展需要精确的后处理分析工具,以便从三维(3D)数据中获取D形二尖瓣环尺寸。评估了两个半自动软件包在处理3D经食管超声心动图(TEE)数据以测量二尖瓣环尺寸方面的一致性。对中重度二尖瓣反流(MR)患者的3DTEE数据使用半自动、独立于供应商(VI)的软件和特定于供应商(VS)的软件进行后处理。两种后处理软件都提供了用于选择经导管瓣膜假体尺寸的关键测量值:瓣环面积、瓣环周长以及瓣环的间隔至外侧距离。三角间距离仅由VS软件提供。采用Bland-Altman分析评估观察者间和观察者内的一致性。在105例患有MR的患者(63.8±11岁;66%为男性)中,28例患有继发性MR,45例患有纤维弹性组织缺乏症,32例患有巴洛病。使用VS软件时,总体人群的瓣环面积尺寸为16.1±4.6 cm,周长为14.4±1.9 cm,三角间距离为3.4±0.5 cm,间隔至外侧距离为3.8±0.6 cm。使用VI软件获得了类似的尺寸:瓣环面积为15.7±4.6 cm,周长为14.5±2.0 cm,间隔至外侧距离为4.1±0.6 cm。两种软件程序的观察者间和观察者内一致性都很好。总之,目前用于二尖瓣环3DTEE数据的后处理软件程序在选择经导管假体尺寸的关键测量方面具有良好的可重复性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03af/7711883/51ea70dd5678/jcdd-07-00048-g001.jpg

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