{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T15:45:33Z","timestamp":1792251933522,"version":"4.4.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Echo Res Pract"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>\n                  <jats:italic>Background<\/jats:italic>: The mitral valve orifice area (MVOA) is difficult to assess accurately by 2D echocardiography because of geometric assumptions; therefore, 3D planimetry may offer advantages. We studied the differences in MVOA measurements between the most frequently used methods, to determine if 3D planimetry would result in the re-grading of severity in any cases, and whether it was a more accurate predictor of clinical outcomes.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Methods<\/jats:italic>: This was a head-to-head comparison of the three most commonly used techniques to grade mitral stenosis (MS) by orifice area and to assess their impact on clinical outcomes. 2D measurements (pressure half-time (PHT), planimetry) and 3D planimetry were performed retrospectively on patients with at least mild MS. The clinical primary endpoint was defined as a composite of MV balloon valvotomy, mitral valve repair or replacement (MVR) and\/or acute heart failure (HF) admissions.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Results<\/jats:italic>: Forty-one consecutive patients were included; the majority were female (35; 85.4%), average age 55 (17) years. Mean and peak MV gradients were 9.4 (4) mmHg and 19 (6) mmHg, respectively. 2D and 3D measures of MVOA differed significantly; mean 2D planimetry MVOA was 1.28 (0.40) cm<jats:sup>2<\/jats:sup>, mean 3D planimetry MVOA 1.15 (0.29) cm<jats:sup>2<\/jats:sup> (<jats:italic>P<\/jats:italic> = 0.003). Mean PHT MVOA was 1.43 (0.44) cm<jats:sup>2<\/jats:sup> (<jats:italic>P<\/jats:italic> = 0.046 and <jats:italic>P<\/jats:italic> &lt; 0.001 in comparison to 2D and 3D planimetry methods, respectively). 3D planimetry reclassified 7 (17%) patients from mild-tomoderate MS, and 1 (2.4%) from moderate to severe. Overall, differences between the two methods were significant (<jats:italic>X<\/jats:italic>\n                  <jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic> &lt; 0.001). Only cases graded as severe by 3D predicted the primary outcome measure compared with mild or moderate cases (odds ratio 5.7).<\/jats:p>\n               <jats:p>\n                  <jats:italic>Conclusion<\/jats:italic>: 3D planimetry in MS returns significantly smaller measurements, which in some cases results in the reclassification of severity. Routine use of 3D may significantly influence the management of MS, with a degree of prediction of clinical outcomes.<\/jats:p>","DOI":"10.1530\/erp-18-0031","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T11:25:20Z","timestamp":1535023520000},"page":"105-111","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of 3D echocardiography on grading of mitral stenosis and prediction of clinical events"],"prefix":"10.1186","volume":"5","author":[{"given":"C.","family":"Bleakley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Eskandari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Aldalati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Moschonas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Whittaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Monaghan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,12,1]]},"reference":[{"key":"504001_CR1","doi-asserted-by":"publisher","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","volume":"2017","author":"H Baumgartner","year":"2017","unstructured":"Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Mu\u00f1oz D, et al. 2017 ESC\/EACTS Guidelines for the management of valvular heart disease. European Heart Journal 2017 2017 2739\u20132791. (https:\/\/doi.org\/10.1093\/eurheartj\/ehx391)","journal-title":"European Heart Journal"},{"key":"504001_CR2","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.jacc.2017.03.011","volume":"2017","author":"RA Nishimura","year":"2017","unstructured":"Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O\u2019Gara PT, et al. 2017 AHA\/ACC focused update of the 2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology 2017 2017 252\u2013289. (https:\/\/doi.org\/10.1161\/CIR.0000000000000503)","journal-title":"Journal of the American College of Cardiology"},{"key":"504001_CR3","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1016\/S0735-1097(00)00852-4","volume":"36","author":"TM Binder","year":"2000","unstructured":"Binder TM, Rosenhek R, Porenta G, Maurer G & Baumgartner H. Improved assessment of mitral valve stenosis by volumetric real-time three-dimensional echocardiography. Journal of the American College of Cardiology 2000 36 1355\u20131361. (https:\/\/doi.org\/10.1016\/S0735-1097(00)00852-4)","journal-title":"Journal of the American College of Cardiology"},{"key":"504001_CR4","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1161\/01.CIR.60.5.1096","volume":"60","author":"L Hatle","year":"1979","unstructured":"Hatle L, Angelsen B & Tromsdal A. Noninvasive assessment of atrioventricular pressure half-time by Doppler ultrasound. Circulation 1979 60 1096\u20131104. (https:\/\/doi.org\/10.1161\/01.CIR.60.5.1096)","journal-title":"Circulation"},{"key":"504001_CR5","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL & MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases 1987 40 373\u2013383. (https:\/\/doi.org\/10.1016\/0021-9681(87)90171-8)","journal-title":"Journal of Chronic Diseases"},{"key":"504001_CR6","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1093\/aje\/kwq433","volume":"173","author":"H Quan","year":"2011","unstructured":"Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, Januel JM & Sundararajan V. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. American Journal of Epidemiology 2011 173 676\u2013682. (https:\/\/doi.org\/10.1093\/aje\/kwq433)","journal-title":"American Journal of Epidemiology"},{"key":"504001_CR7","first-page":"227","volume":"8","author":"F Mahmood","year":"2015","unstructured":"Mahmood F, Owais K, Taylor C, Montealegre-Gallegos M, Manning W, Matyal R & Khabbaz KR. Three-dimensional printing of mitral valve using echocardiographic data. JACC: Cardiovascular Imaging 2015 8 227\u2013229. (https:\/\/doi.org\/10.1016\/j.jcmg.2014.06.020)","journal-title":"JACC: Cardiovascular Imaging"},{"key":"504001_CR8","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1111\/echo.13786","volume":"35","author":"HM Mahmoud Elsayed","year":"2018","unstructured":"Mahmoud Elsayed HM, Hassan M, Nagy M, Amin A, Elguindy A, Wagdy K & Yacoub M. A novel method to measure mitral valve area in patients with rheumatic mitral stenosis using three-dimensional transesophageal echocardiography: feasibility and validation. Echocardiography 2018 35 368\u2013374. (https:\/\/doi.org\/10.1111\/echo.13786)","journal-title":"Echocardiography"},{"key":"504001_CR9","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1111\/echo.13558","volume":"34","author":"F Sampaio","year":"2017","unstructured":"Sampaio F, Ladeiras-Lopes R, Almeida J, Fonseca P, Fontes-Carvalho R, Ribeiro J & Gama V. Three-dimensional proximal flow convergence automatic calculation for determining mitral valve area in rheumatic mitral stenosis. Echocardiography 2017 34 1002\u20131009. (https:\/\/doi.org\/10.1111\/echo.13558)","journal-title":"Echocardiography"},{"key":"504001_CR10","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1016\/j.echo.2014.04.023","volume":"27","author":"JA de Agustin","year":"2014","unstructured":"de Agustin JA, Mejia H, Viliani D, Marcos-Alberca P, Gomez de Diego JJ, Nu\u00f1ez-Gil IJ, Almeria C, Rodrigo JL, Luaces M, Garcia-Fernandez MA, et al. Proximal flow convergence method by three-dimensional color Doppler echocardiography for mitral valve area assessment in rheumatic mitral stenosis. Journal of the American Society of Echocardiography 2014 27 838\u2013845. (https:\/\/doi.org\/10.1016\/j.echo.2014.04.023)","journal-title":"Journal of the American Society of Echocardiography"},{"key":"504001_CR11","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1136\/heartjnl-2012-302742","volume":"99","author":"S-Y Min","year":"2013","unstructured":"Min S-Y, Song J-M, Kim Y-J, Park H-K, Seo M-O, Lee M-S, Kim DH, Kang DH & Song JK. Discrepancy between mitral valve areas measured by two-dimensional planimetry and three-dimensional transoesophageal echocardiography in patients with mitral stenosis. Heart 2013 99 253\u2013258. (https:\/\/doi.org\/10.1136\/heartjnl-2012-302742)","journal-title":"Heart"},{"key":"504001_CR12","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/j.euje.2006.08.008","volume":"8","author":"L de P\u00e9rez Isla","year":"2007","unstructured":"P\u00e9rez de Isla L, Casanova C, Almer\u00eda C, Rodrigo JL, Cordeiro P, Mataix L, Aubele AL, Lang R & Zamorano JL. Which method should be the reference method to evaluate the severity of rheumatic mitral stenosis? Gorlin\u2019s method versus 3D-echo. European Journal of Echocardiography 2007 8 470\u2013473. (https:\/\/doi.org\/10.1016\/j.euje.2006.08.008)","journal-title":"European Journal of Echocardiography"},{"key":"504001_CR13","first-page":"580","volume":"4","author":"D Schlosshan","year":"2011","unstructured":"Schlosshan D, Aggarwal G, Mathur G, Allan R & Cranney G. Real-time 3D transesophageal echocardiography for the evaluation of rheumatic mitral stenosis. JACC: Cardiovascular Imaging 2011 4 580\u2013588. (https:\/\/doi.org\/10.1016\/j.jcmg.2010.12.009)","journal-title":"JACC: Cardiovascular Imaging"},{"key":"504001_CR14","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1136\/hrt.40.2.131","volume":"40","author":"L Hatle","year":"1978","unstructured":"Hatle L, Brubakk A, Tromsdal A & Angelsen B. Noninvasive assessment of pressure drop in mitral stenosis by Doppler ultrasound. British Heart Journal 1978 40 131\u2013140. (https:\/\/doi.org\/10.1136\/hrt.40.2.131)","journal-title":"British Heart Journal"},{"key":"504001_CR15","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1161\/01.CIR.78.4.980","volume":"78","author":"JD Thomas","year":"1988","unstructured":"Thomas JD, Wilkins GT, Choong CY, Abascal VM, Palacios IF, Block PC & Weyman AE. Inaccuracy of mitral pressure half-time immediately after percutaneous mitral valvotomy. Dependence on transmitral gradient and left atrial and ventricular compliance. Circulation 1988 78 980\u2013993. (https:\/\/doi.org\/10.1161\/01.CIR.78.4.980)","journal-title":"Circulation"}],"container-title":["Echo Research &amp; Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1530\/ERP-18-0031\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1530\/ERP-18-0031.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1530\/ERP-18-0031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1530\/ERP-18-0031.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T02:08:51Z","timestamp":1650593331000},"score":1,"resource":{"primary":{"URL":"https:\/\/echo.biomedcentral.com\/articles\/10.1530\/ERP-18-0031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["504001"],"URL":"https:\/\/doi.org\/10.1530\/erp-18-0031","relation":{},"ISSN":["2055-0464"],"issn-type":[{"value":"2055-0464","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]},"assertion":[{"value":"15 August 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 August 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}