الفهرس 
Title : Study of the incremental value Of 3D echocardiography over 2D echocardiography in evaluation of left ventricular function in patients with severe primary mitral regurgitation
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Abstract
Purpose: Patients with severe asymptomatic mitral regurgitation have special hemodynamics in the form of increased preload without increase in the afterload resulting in falsely normal or even higher ejection fraction. After surgical correction according to the available guidelines some patients might develop left ventricular systolic dysfunction. We assessed LV systolic function by transthoracic echocardiography with both 2D and 3D modalities, in order to find a more sensitive parameter for early surgery. Methods: The study included 70 asymptomatic primary severe mitral regurgitation patients; 35 with rheumatic etiology and 35 with mitral valve prolapse. All patients were in normal sinus rhythm, with no or mild other valvular lesions. All patients had no history suggestive of coronary artery disease, or other comorbidies (diabetes or hypertension). In addition, age and gender matched 35 healthy subjects were studied as control group. All the studied population underwent full history taking, clinical examination and 12 leads resting ECG. Detailed TTE with 2D was done to assess the LV function (LVIDs, EF, FS, LV mass, LVMI, LVVI, RWT, Tei index, and Tei index by tissue doppler). Left ventricular function was also assessed by 3D modality (EF, LVEDV, LVESV, LVEDVI, LVESVI). Mitral regurgitation severity was assessed by regurgitation fraction (RF), regurgitant volume (R Vol), and regurgitant orifice area (ROA). Results: We found significant statistical difference between the diseased group and the control group regarding LV systolic parameters both by 2D and 3D echo. Further analysis through RHD and MVP group, there was no significant difference regarding LV systolic function except for the Tei index which was significantly lower in RHD group (p=0.002). Conclusion: There is no additive value offered by 3D echo modality in the assessment of left ventricular function in patients with severe primary mitral regurgitation, and the 2D echo modality represents a feasible, easy, and available noninvasive assessment