{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T20:45:57Z","timestamp":1778186757351,"version":"3.51.4"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,1,29]],"date-time":"2016-01-29T00:00:00Z","timestamp":1454025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2016,6]]},"abstract":"Background<\/jats:title>Determining the severity of mitral stenosis (MS<\/jats:styled-content>) is important for both prognostic and therapeutic implications. Mitral valve area (MVA<\/jats:styled-content>) calculation techniques have more limitations. Mitral leaflet separation (MLS<\/jats:styled-content>) is a precise and operator friendly alternative to planimetry. In contrast to previous researchers, we have used a novel 3D Xplane technique to validate MLS<\/jats:styled-content> for assessing the severity of MS<\/jats:styled-content>. 3D Xplane is superior for validation of MLS<\/jats:styled-content> due to simultaneous real time acquisition of MLS<\/jats:styled-content> in parasternal long\u2010axis view and corresponding MVA<\/jats:styled-content> by planimetry in parsternal short\u2010axis view.<\/jats:p><\/jats:sec>Methods<\/jats:title>It was a prospective observational single center study. A total of 174 patients with MS<\/jats:styled-content> were evaluated for MVA<\/jats:styled-content> estimation by various echocardiographic modalities. Maximum leaflet separation and corresponding planimetered MVA<\/jats:styled-content> were measured using novel 3D Xplane technique.<\/jats:p><\/jats:sec>Results<\/jats:title>With 3D Xplane technique, there was strong positive correlation between planimetered MVA<\/jats:styled-content> and MLS<\/jats:styled-content> (R = 0.925, P < 0.001), irrespective of coexisting MR<\/jats:styled-content> (R = 0.886, P < 0.001) or AF<\/jats:styled-content> (R = 0.912, P < 0.001). Receiver operating characteristic curves of MLS<\/jats:styled-content> demonstrated AUC<\/jats:styled-content> for mild and severe MS<\/jats:styled-content> to be 0.966 and 0.995, respectively. MLS<\/jats:styled-content> less than 8.62 mm predicted severe MS<\/jats:styled-content> with 95.5% sensitivity and 94.7% specificity and MLS<\/jats:styled-content> more than 12.23 mm predicted mild MS<\/jats:styled-content> with 93.2% sensitivity and 91.4% specificity.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In our study, a strong correlation between planimetered MVA<\/jats:styled-content> and MLS<\/jats:styled-content> was found using 3D Xplane technique. 3D Xplane thus validates and standardizes MLS<\/jats:styled-content> by excluding errors due to temporal and spatial variations which are important limitations of 2D echocardiography.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13183","type":"journal-article","created":{"date-parts":[[2016,1,30]],"date-time":"2016-01-30T04:40:56Z","timestamp":1454128856000},"page":"896-901","source":"Crossref","is-referenced-by-count":7,"title":["3D Xplane Echocardiographic Technique for Validation of Mitral Leaflet Separation to Assess Severity of Mitral Stenosis"],"prefix":"10.1111","volume":"33","author":[{"given":"Rajendra K.","family":"Gokhroo","sequence":"first","affiliation":[{"name":"Postgraduate Department of Cardiology JLN Medical College Ajmer Rajasthan India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhanwar L.","family":"Ranwa","sequence":"additional","affiliation":[{"name":"Postgraduate Department of Cardiology JLN Medical College Ajmer Rajasthan India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamal","family":"Kishor","sequence":"additional","affiliation":[{"name":"Postgraduate Department of Cardiology JLN Medical College Ajmer Rajasthan India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kumari","family":"Priti","sequence":"additional","affiliation":[{"name":"Postgraduate Department of Cardiology JLN Medical College Ajmer Rajasthan India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ananthraj","family":"Avinash","sequence":"additional","affiliation":[{"name":"Postgraduate Department of Cardiology JLN Medical College Ajmer Rajasthan India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Escorts Heart Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devendra","family":"Bisht","sequence":"additional","affiliation":[{"name":"ACE Heart and Vascular Institute Mohali Punjab India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90556-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)80023-A"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0742-2822.2004.03057.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(05)80091-2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80223-2"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.07.012"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(83)90284-3"},{"key":"e_1_2_6_9_1","first-page":"563","article-title":"Mitral leaflet separation index\u2010A simple novel index to assess the severity of mitral stenosis","volume":"60","author":"Raj BSV","year":"2008","journal-title":"Indian 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