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European Heart Journal 1999 20(8):619-627; doi:10.1053/euhj.1998.1342
Copyright © 1999 by the European Society of Cardiology.
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Three-dimensional Doppler. Techniques and clinical applications

R. De Simonea,f1, G. Glombitzab, C.F. Vahla, H.P. Meinzerb and S. Hagla

a Abteilung für Herzchirurgie, University of Heidelberg, Heidelberg, Germany
b Department of Medical and Biological Informatics, Deutsches Krebsforschungszentrum, Heidelberg, Germany

revised September 24, 1998; accepted September 30, 1998

Abstract

Aims

Colour Doppler is the most widely used technique for assessing valve disease, but eccentric regurgitant jets cannot be visualized and measured by conventional 2D techniques. We have developed a new procedure for three-dimensional (3D) reconstruction of colour Doppler signals.

Methods and Results

Fifty patients with mitral regurgitation underwent transoesophageal echocardiography and 3D acquisition. The severity of mitral regurgitation was assessed by angiography and the regurgitant volumes were measured by pulsed Doppler. The jet areas were calculated by planimetry from conventional colour Doppler; the jet volumes were obtained by 3D Doppler. A higher degree of mitral regurgitation was found in the patients with eccentric jets. While jet areas showed poor correlation with regurgitant volumes (r=0·61), jet volumes correlated significantly with regurgitant volumes (r=0·93;P<0·001). While jet areas failed to identify patients with different grades of regurgitation, jet volumes could so discriminate.

Conclusions

3D Doppler revealed new patterns of regurgitant flow and allowed a more accurate semiquantitative assessment of complex asymmetrical regurgitant jets. Three-dimensional colour Doppler has a great potential for becoming a reference method for the assessment of patients with heart valve disease.

Key Words: Three-dimensional echocardiography, colour Doppler, Heart valve disease, mitral regurgitation

f1 Correspondence:Raffaele De Simone, MD, University of Heidelberg, Abteilung für Herzchirurgie, Im Neuenheimer Feld, 120, D-69120 Heidelberg, Germany.

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