Comparison of Transesophageal and Transthoracic Echocardiographic Measurements of Mechanism and Severity of Mitral Regurgitation in Ischemic Cardiomyopathy (from the Surgical Treatment of Ischemic Heart Failure Trial)

Paul A. Grayburn, Lilin She, Brad J. Roberts, Krzysztof S. Golba, Krzysztof Mokrzycki, Jaroslaw Drozdz, Alexander Cherniavsky, Roman Przybylski, Krzysztof Wrobel, Federico M. Asch, Thomas A. Holly, Haissam Haddad, Michael Yii, Gerald Maurer, Irving Kron, Hartzell Schaff, Eric J. Velazquez, Jae K. Oh

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Abstract

Mitral regurgitation (MR) is common in ischemic heart disease and contributes to symptoms and mortality. This report compares the results of baseline transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) imaging of the mechanism and severity of functional MR in patients with ischemic cardiomyopathy in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Independent core laboratories measured both TTE and TEE images on 196 STICH participants. Common measurements to both models included MR grade, mitral valve tenting height and tenting area, and mitral annular diameter. For each parameter, correlations were assessed using Spearman rank correlation coefficients. A modest correlation was present between TEE and TTE for overall MR grade (n = 176, r = 0.52). For mechanism of MR, modest correlations were present for long-axis tenting height (n = 152, r = 0.35), tenting area (n = 128, r = 0.27), and long-axis mitral annulus diameter (n = 123, r = 0.41). For each measurement, there was significant scatter. Potential explanations for the scatter include different orientation of the imaging planes between TEE and TTE, a mean temporal delay of 6 days between TEE and TTE, and statistically significant differences in heart rate and blood pressure and weight between studies. In conclusion, TEE and TTE measurements of MR mechanism and severity correlate only modestly with enough scatter in the data that they are not interchangeable.

Original languageEnglish (US)
Article number21243
Pages (from-to)913-918
Number of pages6
JournalAmerican Journal of Cardiology
Volume116
Issue number6
DOIs
StatePublished - Sep 15 2015
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Grayburn, P. A., She, L., Roberts, B. J., Golba, K. S., Mokrzycki, K., Drozdz, J., Cherniavsky, A., Przybylski, R., Wrobel, K., Asch, F. M., Holly, T. A., Haddad, H., Yii, M., Maurer, G., Kron, I., Schaff, H., Velazquez, E. J., & Oh, J. K. (2015). Comparison of Transesophageal and Transthoracic Echocardiographic Measurements of Mechanism and Severity of Mitral Regurgitation in Ischemic Cardiomyopathy (from the Surgical Treatment of Ischemic Heart Failure Trial). American Journal of Cardiology, 116(6), 913-918. [21243]. https://doi.org/10.1016/j.amjcard.2015.06.015