Evaluation of aortic regurgitation with cardiac magnetic resonance imaging: a systematic review

Abstract

This review summaries the utility, application and data supporting use of cardiac magnetic resonance imaging (CMR) to evaluate and quantitate aortic regurgitation. We systematically searched Medline and PubMed for original research articles published since 2000 that provided data on the quantitation of aortic regurgitation by CMR and identified 11 articles for review. Direct aortic measurements using phase contrast allow quantitation of volumetric flow across the aortic valve and are highly reproducible and accurate compared with echocardiography. However, this technique requires diligence in prescribing the correct imaging planes in the aorta. Volumetric analytic techniques using differences in ventricular volumes are also highly accurate but less than phase contrast techniques and only accurate when concomitant valvular disease is absent. Comparison of both aortic and ventricular data for internal data verification ensures fidelity of aortic regurgitant data. CMR data can be applied to many types of aortic valve regurgitation including combined aortic stenosis with regurgitation, congenital valve diseases and post-transcatheter valve placement. CMR also predicts those patients who progress to surgery with high overall sensitivity and specificity. Future studies of CMR in patients with aortic regurgitation to quantify the incremental benefit over echocardiography as well as prediction of cardiovascular events are warranted.

Randomised comparison of a balloon-expandable and self-expandable valve with quantitative assessment of aortic regurgitation using magnetic resonance imaging

“…A problem of previous studies is the wide range of AR rates, which are partly due to non-standardised and non-quantitative AR measurements that remain imprecise due to under-or overestimation of AR as well as inter-observer variability [4,[6][7][8]. Since MRI is currently considered to be the most accurate method available with low intra-and inter-observer variability and high accuracy, resulting in good reproducibility [9,10,16,23,24], the assessment and comparison of AR severity between the two valves has been assessed in this study as accurately as possible. The accuracy of AR is important, since AR is a frequent remaining problem that is associated with an increased 30-day and 1-year mortality [3].…”

“…Wide ranges of AR rates have been reported, partly due to non-standardised and non-quantitative measurements [3][4][5], resulting in under-or overestimation of AR [6][7][8] as well as inter-observer variability. So far, quantitative phase-contrast magnetic resonance imaging (MRI) has proved to be the most accurate method for assessing AR and the best method to improve the understanding of the relation between AR severity and clinical outcomes [9,10]. Over the past decade, several improvements to address AR have been introduced in different valves with different expansion systems.…”

Aggravation of atrial arrhythmia by amiodarone during the perinatal period

“…Two categories of the condition exist: in 1, arrhythmia is the only reason for ventricular dysfunction (arrhythmia-induced), and in the other, the arrhythmia exacerbates ventricular dysfunction and/or worsens HF in a patient with concomitant heart disease (arrhythmia-mediated). [8] Therefore, our postpartum patient was considered to have atrial tachycardia-mediated acute HF based on HD-HDP.…”

Investigation of phase-contrast magnetic resonance imaging underestimation of turbulent flow through the aortic valve phantom: experimental and computational study using lattice Boltzmann method

“…Furthermore, in the quantification of valvular regurgitation, there is an unresolved question regarding the position of the slice for measurements of the forward and backward flow since the presence of turbulence and the motion of valve complicate its positioning [29]. Different authors choose different sites for their measurements [36,23,7,4,6,26]. Using the 4D PC-MRI in conjunction with subsequent post-processing might produce better results [11].…”