Análisis de las características de la válvula mitral en ecocardiograma tridimensional Three-Dimensional Echocardiographic Analysis of Mitral Valve Characteristics

Introduction: Three-dimensional transesophageal echocardiography (3D TEE) is a useful tool, particularly for the evaluation of mitral valve disease. There are few reports in the literature, none of our country, about the normal values in order to define the disease. Objective: The aim of this study was to define the normal values of the mitral valve annulus and leaflets in a population without heart disease using 3D TEE. Methods: Twenty-six patients without heart disease were prospectively included and underwent two-dimensional and 3D TEE. The best 3D volume acquired was used to construct a three dimensional model of the mitral valve to measure the mitral valve leaflets and annulus (indexed for body surface area). Data are presented as median with interquartile range. Results: Age was 64.5 years (39.1-69.7) and 46% were men. Mitral annulus measurements were: intercommissural diameter 18.7 mm (16.5-19.9), anteroposterior diameter 16.4 mm (15.1-17.8), height 4.4 mm (3.6-5.4), circumference in projection plane 55.1 mm (52.2-60), 3D circumference 57.8 mm (55.5-64.1), area in projection plane 433.9 mm2 (405.3-489) and 3D area 457.8 mm2 (431.2-515.8). The leaflets measurements were: anterior leaflet length 13.4 mm (12.4-14), anterior leaflet area 328.6 mm2 (297-359.8), posterior leaflet length 7.8 mm (7.1-8.3) and posterior leaflet area 242 mm2 (214.3-265.5). The reproducibility of mitral annulus measurements in 3D was evaluated and showed good intraobserver and interobserver agreement. Conclusions: Results show reference values of the mitral valve leaflets and annulus estimated by 3D TEE in a population without heart disease. These data lay the foundations for future studies which, by associating similar measurements across all the ranges of severity of mitral valve disease, may prospectively define the sensitivity and specificity of the method for mitral valve assessment.