Application of trans-thoracic echocardiography and coronary CT angiography to diagnose mitral valve prolapse

J Cardiothorac Surg. 2019 Jun 24;14(1):115. doi: 10.1186/s13019-019-0925-8.

Abstract

Objective: At present, multi-detector cardiac CT has been widely applied in the detection of heart valve morphology and function. This study aims to compare the coronary CT angiography and trans-thoracic echocardiography for patients with mitral valve prolapse.

Methods: CT angiography and trans-thoracic echocardiography were adopted to detect the movement range and thickness of valvula bicuspidalis. The ultrasonic parameters of CT angiography were considered as standard reference value.

Results: Receiver operating characteristic (ROC) curve showed that the area of mitral valve motion amplitude under ROC curve was 95% detected by CT angiography with statistical significance (P < 0.001). Based on the intercept point on the ROC curve, the sensitivity and accuracy of mitral valve amplitude detected by CT angiography was 69.2 and 95.6%, the false positive and false negative rate was 5.2 and 32.4%, the predicted value of positive and negative was 92.9 and 76.9% and the consistency rate of motion range and leaf thickness detected by CT angiography was 83.3 and 47.5%. Trans-thoracic echocardiography showed that the thickness and motion range of mitral leaflet was (1.95 ± 0.22) mm and (1.5 ± 2.28) mm. The thickness and motion range of mitral leaflet that detected by CT was (2.00 ± 0.54) mm and (3.76 ± 2.1) mm.

Conclusion: The accuracy and reliability of CT angiography for patients with mitral valve prolapse are higher than those of trans-thoracic echocardiography.

Keywords: Coronary CT angiography; Mitral valve prolapse; Trans-thoracic echocardiography.

MeSH terms

  • Aged
  • Computed Tomography Angiography*
  • Coronary Angiography*
  • Echocardiography*
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / physiopathology
  • Mitral Valve Prolapse / diagnostic imaging*
  • Mitral Valve Prolapse / physiopathology
  • Reproducibility of Results
  • Sensitivity and Specificity