Cardiac Magnetic Resonance Imaging Versus Transthoracic Echocardiography for Prediction of Outcomes in Chronic Aortic or Mitral Regurgitation

Harris, A. W.; Krieger, Eric V.; Kim, Minkyu; Cawley, Peter J.; Owens, David S.; Hamilton-Craig, Christian; Maki, Jeffrey H.; Otto, Catherine M.

doi:10.1016/j.amjcard.2016.12.017

Cited by 51 publications

(39 citation statements)

References 28 publications

(36 reference statements)

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“…The recommended method of measuring AVVR by 2D CMR is through the volumetric (VOL) method-the difference between ventricular stroke volume (by planimetry) and forward flow across the respective semilunar valve (assessed by phase contrast imaging (PC) CMR) [9,[13][14][15][16][17][18]. Compared to echocardiography, the VOL method has better reliability [9,10,16,19,20] and accuracy based on correlation with outcome measures including surgical indication and ventricular remodeling after surgery [9,20,21]. However, in patients with complex CHD, the reliance on two separate CMR techniques and measurement errors inherent in planimetry can negatively impact accuracy and reliability [16].…”

Section: Introductionmentioning

confidence: 99%

Direct measurement of atrioventricular valve regurgitant jets using 4D flow cardiovascular magnetic resonance is accurate and reliable for children with congenital heart disease: a retrospective cohort study

Jacobs

Rigdon

Chan

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background: 3D-time resolved flow (4DF) cardiovascular magnetic resonance (CMR) with retrospective analysis of atrioventricular valve regurgitation (AVVR) allows for internal validation by multiple direct and indirect methods. Limited data exist on direct measurement of AVVR by 4DF CMR in pediatric congenital heart disease (CHD). We aimed to validate direct measurement of the AVVR jet as accurate and reliable compared to the volumetric method (clinical standard by 2D CMR) and as a superior method of internal validation than the annular inflow method. Methods: We identified 44 consecutive patients with diverse CHD referred for evaluation of AVVR by CMR. 1.5 T or 3 T scanners, intravenous contrast, and a combination of parallel imaging and compressed sensing were used. Four methods of measuring AVVR volume (RVol) were used: volumetric method (VOL; the clinical standard) = stroke volume by 2D balanced steady-state free precessionsemilunar valve forward flow (SLFF); annular inflow method (AIM) = atrioventricular valve forward flow [AVFF]semilunar valve net flow (SLNF); and direct measurement (JET). AVFF was measured using static and retrospective valve tracking planes. SLFF, SLNF, AVFF, and JET were measured by 4DF phase contrast. Regurgitant fraction was calculated as [RVol/(RVol+SLNF)]× 100. Statistical methods included Spearman, Wilcoxon rank sum test/Student paired ttest, Bland Altman analysis, and intra-class coefficient (ICC), where appropriate.

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Section: Introductionmentioning

confidence: 99%

Direct measurement of atrioventricular valve regurgitant jets using 4D flow cardiovascular magnetic resonance is accurate and reliable for children with congenital heart disease: a retrospective cohort study

Jacobs

Rigdon

Chan

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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“…10 Even in expert hands, TTE has limited interobserver agreement in distinguishing severe from nonsevere regurgitation, and it may be particularly limited when regurgitant jets are eccentric, multiple, or variable in duration. 11,12 In contrast, quantification of mitral regurgitant volume with multiplanar cardiac magnetic resonance imaging (MRI) shows high reproducibility, 13 better predictive power of patient outcomes for chronic regurgitation, 14 and greater correlation with left ventricular remodeling after surgical repair. 15 However, multiplanar cardiac MRI is labor-intensive and requires specialized local expertise, limiting its availability.…”

mentioning

confidence: 99%

4D flow MRI quantification of mitral and tricuspid regurgitation: Reproducibility and consistency relative to conventional MRI

Feneis

Kyubwa

Atianzar³

et al. 2018

Magnetic Resonance Imaging

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“…Importantly, we found no statistically significant differences between the two techniques in the quantitative assessments (figures 1 and 2). For the comparison, 2DPC MRI was used as the reference technique because this sequence has been previously validated by comparison with echocardiography for AR quantification 7 9–11…”

Section: Discussionmentioning

confidence: 99%

“…2DPC MRI can also measure flow, velocity and direction accurately and reproducibly,7 even considering the limitations8 of 2DPC MRI (eg, the assumption of laminar flow and a dependency on the flow intercept angle). In fact, some studies have shown that 2DPC MRI could be superior to transthoracic echography in quantifying AR for prognostic purposes 9–11…”

Section: Introductionmentioning

confidence: 99%

Clinical use of 4D flow MRI for quantification of aortic regurgitation

et al. 2020

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ObjectiveThe main objective of the present study was to compare the use of four-dimensional (4D) flow MRI with the habitual sequence (two-dimensional phase-contrast (2DPC) MRI) for the assessment of aortic regurgitation (AR) in the clinical routine.MethodsThis was a retrospective, observational cohort study of patients with varying grades of AR. For the purposes of the present study, we selected all the cases with a regurgitant fraction (RF)>5% as determined by 2DPC MRI (n=34). In all cases, both sequences (2DPC and 4D flow MRI) were acquired in a single session to ensure comparability. We compared the results of the two techniques by evaluating forward flow, regurgitant flow and regurgitation fraction. Then, the patients were divided into subgroups to determine if these factors had any influence on the measurements: aortic diameter (≤ vs >38 mm), valve anatomy (tricuspid vs bicuspid/quadricuspid), stenosis (gradient ≥15 vs <15) and region of interest location (aortic valve vs sinotubular junction).ResultsNo statistically significant differences were observed between the two techniques with Pearson’s correlation coefficients (r) of forward flow (r=0.826/p value<0001), regurgitant flow (r=0.866/p value<0001) and RF (r=0.761/p value<0001).ConclusionsThe findings of this study confirm the value of 4D flow MRI for grading AR in clinical practice with an excellent correlation with the standard technique (2DPC MRI).

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Cardiac Magnetic Resonance Imaging Versus Transthoracic Echocardiography for Prediction of Outcomes in Chronic Aortic or Mitral Regurgitation

Cited by 51 publications

References 28 publications

Direct measurement of atrioventricular valve regurgitant jets using 4D flow cardiovascular magnetic resonance is accurate and reliable for children with congenital heart disease: a retrospective cohort study

Direct measurement of atrioventricular valve regurgitant jets using 4D flow cardiovascular magnetic resonance is accurate and reliable for children with congenital heart disease: a retrospective cohort study

4D flow MRI quantification of mitral and tricuspid regurgitation: Reproducibility and consistency relative to conventional MRI

Clinical use of 4D flow MRI for quantification of aortic regurgitation

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