The Correlation between Three-Dimensional Vena Contracta Area and Aortic Regurgitation Index in Patients with Aortic Regurgitation

Objectives: The aims of this study are to explore the correlation between the three-dimensional vena contracta (3D VC) area and the aortic regurgitation (AR) index and to determine AR severity using the 3D VC area. Background: The geometry of regurgitant jets is complex in patients with AR. The 3D VC area can be easily cropped using any plane and we can obtain the complex geometry of the VC area. Methods: Full-volume three-dimensional (3D) color flow datasets were generated using the trans-thoracic parasternal approach. The AR jet could be well visualized and analyzed in three orthogonal planes using dedicated software. Results: We consecutively analyzed 77 AR patients with comprehensive 2D and 3D echocardiographic data. The 3D VC area increased proportionately with increasing AR severity using the AR index method (F = 86.1, P < 0.001) and correlated well with effective regurgitant orifice (P < 0.001). The cutoff value of the VC area was < 30 mm2 (sensitivity = 90% and specificity = 88%) for predicting mild AR and > 50 mm2 (sensitivity = 92% and specificity = 87%) for predicting severe AR. Conclusion: 3D color flow VC area measurement provides a simple and accurate method for assessing the severity of AR. (ECHOCARDIOGRAPHY 2010;27:161-166).