Quantification of mitral-valve regurgitation in a paediatric population by real-time three-dimensional echocardiography

SummaryBackgroundEvaluation of mitral-regurgitation (MR) severity in infants is challenging. Real-time three-dimensional echocardiography (RT3DE) allows accurate left-ventricular volumetric measurements in adults.AimsTo validate RT3DE by measuring stroke volume in a normal paediatric population, then to use this new method to calculate regurgitant volume in paediatric patients with MR.MethodsFifty-four patients, aged one week to 19 years, (29 without and 25 with MR) had two-dimensional echocardiography coupled with RT3DE left-ventricular volumetric acquisition. Stroke volume was calculated by the Doppler method at the aortic annulus (SVD). End-systolic and end-diastolic left-ventricular volumes were measured using the QLab semi-automated method; three-dimensional stroke volume (SV3D) was calculated as their difference. In the MR group, regurgitant volume was calculated by the PISA method (RVPISA) and as the difference between SV3D and SVD (RV3D). Regurgitant fraction was also evaluated by these methods (RFPISA and RF3D).ResultsMeasurement feasibility was 88%. In the normal group, SV3D (27.9±18.1ml) was highly correlated with SVD (30.7±19.6ml; r=0.98; p<0.000). In the MR group, RVPISA (15.7±14.4ml) and RV3D (11.0±10.2ml) were well correlated (r=0.83; p