Format

Send to

Choose Destination
J Am Soc Echocardiogr. 2019 Feb;32(2):303-316.e4. doi: 10.1016/j.echo.2018.08.010. Epub 2018 Oct 5.

Validation of a Holographic Display for Quantification of Mitral Annular Dynamics by Three-Dimensional Echocardiography.

Author information

1
Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: kardum@ous-hf.no.
2
Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
3
Kalkulo AS, Fornebu, Norway.
4
Institute for Surgical Research, The Intervention Center, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
5
Department of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
6
Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
7
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Bergen, Norway.

Abstract

BACKGROUND:

Three-dimensional (3D) echocardiography with multiplanar reconstruction (MPR) is used clinically to quantify the mitral annulus. MPR images are, however, presented on a two-dimensional screen, calling into question their accuracy. An alternative to MPR is an autostereoscopic holographic display that enables in-depth visualization of 3D echocardiographic data without the need for special glasses. The aim of this study was to validate an autostereoscopic display using sonomicrometry as a gold standard.

METHODS:

In 11 anesthetized open-chest pigs, sonomicrometric crystals were placed along the mitral annulus and near the left ventricular apex. High-fidelity catheters measured left atrial and ventricular pressures. Adjustments of pre- and afterload were done by constriction of the inferior vena cava and the ascending aorta, respectively. Three-dimensional epicardial echocardiography was obtained from an apical view and converted to the autostereoscopic display. A 3D virtual semitransparent annular surface (VSAS) was generated to measure commissure width (CW), septal-lateral length, area of the mitral annular surface, nonplanarity angle, and the annular height-to-commissure width ratio in mid-systole and late diastole.

RESULTS:

Mitral annular measurements from the 3D VSAS derived from the 3D echocardiographic images and autostereoscopic display correlated well with sonomicrometry over a range of loading conditions: CW length (r = 0.98, P < .00001), septal-lateral length (r = 0.98, P < .00001), annular surface area (r = 0.93, P < .001), nonplanarity angle (r = 0.87, P < .001), and annular height-to-commissure width ratio (r = 0.85, P < .01). The 3D VSAS showed better agreement with the sonomicrometric measurements compared with MPR.

CONCLUSIONS:

Mitral annular measurements using 3D VSAS correlate well with sonomicrometry over a range of loading conditions and may represent a powerful tool for noninvasive quantification of mitral annular dynamics.

KEYWORDS:

3D echocardiography; Mitral valve; Mitral valve annulus; Sonomicrometry

PMID:
30293779
DOI:
10.1016/j.echo.2018.08.010
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science Icon for Norwegian BIBSYS system
Loading ...
Support Center