{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:24:38Z","timestamp":1740137078369,"version":"3.37.3"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T00:00:00Z","timestamp":1495065600000},"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":[[2017,7]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Management of patients with mitral stenosis (<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>) depends heavily on the accurate quantification of mitral valve area (<jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content>) using echocardiography. All currently used two\u2010dimensional (2D) methods have limitations. Estimation of <jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content> using the proximal isovelocity surface area (<jats:styled-content style=\"fixed-case\">PISA<\/jats:styled-content>) method with real time three\u2010dimensional (3D) echocardiography may circumvent those limitations. We aimed to evaluate the accuracy of 3D direct measurement of <jats:styled-content style=\"fixed-case\">PISA<\/jats:styled-content> in the estimation of <jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010seven consecutive patients (median age of 63\u00a0years; 77.8% females) with rheumatic <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> were prospectively studied. Transthoracic and transesophageal echocardiography with 2D and 3D acquisitions were performed on the same day. The reference method for <jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content> quantification was valve planimetry after 3D\u2010volume multiplanar reconstruction. A semi\u2010automated software was used to calculate the 3D flow convergence volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to <jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content> estimation using 3D planimetry, 3D <jats:styled-content style=\"fixed-case\">PISA<\/jats:styled-content> showed the best correlation (rho=0.78, <jats:italic>P<\/jats:italic>&lt;.0001), followed by pressure half\u2010time (<jats:styled-content style=\"fixed-case\">PHT<\/jats:styled-content>: rho=0.66, <jats:italic>P<\/jats:italic>&lt;.001), continuity equation (<jats:styled-content style=\"fixed-case\">CE<\/jats:styled-content>: rho=0.61, <jats:italic>P<\/jats:italic>=.003), and 2D <jats:styled-content style=\"fixed-case\">PISA<\/jats:styled-content> (rho=0.26, <jats:italic>P<\/jats:italic>=.203). Bland\u2010Altman analysis revealed a good agreement for <jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content> estimation with 3D <jats:styled-content style=\"fixed-case\">PISA<\/jats:styled-content> (mean difference \u22120.03\u00a0cm<jats:sup>2<\/jats:sup>; limits of agreement (<jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>) \u22120.40\u20130.35), in contrast to wider <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content> for 2D methods: <jats:styled-content style=\"fixed-case\">CE<\/jats:styled-content> (mean difference 0.02\u00a0cm<jats:sup>2<\/jats:sup>, <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content> \u22120.56\u20130.60); <jats:styled-content style=\"fixed-case\">PHT<\/jats:styled-content> (mean difference 0.31\u00a0cm<jats:sup>2<\/jats:sup>, <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content> \u22120.32\u20130.95); 2D <jats:styled-content style=\"fixed-case\">PISA<\/jats:styled-content> (mean difference \u22120.03\u00a0cm<jats:sup>2<\/jats:sup>, <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content> \u22120.92\u20130.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content> estimation using 3D <jats:styled-content style=\"fixed-case\">PISA<\/jats:styled-content> was feasible and more accurate than 2D methods. Its introduction in daily clinical practice seems possible and may overcome technical limitations of 2D methods.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13558","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T10:59:05Z","timestamp":1495105145000},"page":"1002-1009","source":"Crossref","is-referenced-by-count":3,"title":["Three\u2010dimensional proximal flow convergence automatic calculation for determining mitral valve area in rheumatic mitral stenosis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9543-2767","authenticated-orcid":false,"given":"Francisco","family":"Sampaio","sequence":"first","affiliation":[{"name":"Cardiology Department Centro Hospitalar de Gaia\/Espinho  Vila Nova de Gaia Portugal"},{"name":"Faculty of Medicine Cardiovascular Research Center University of Porto  Porto 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