Quantification of Aortic Valve Regurgitation by Pulsed Doppler Examination of the Left Subclavian Artery Velocity Contour: A Validation Study with Cardiovascular Magnetic Resonance Imaging

Spampinato, Ricardo; Jahnke, Cosima; Paetsch, Ingo; Hilbert, Sebastian; Busch, Franziska; Schloma, V.; Dmitrieva, Yaroslava; Thome, Fernanda Bonamigo; Löbe, Susanne; Strotdrees, Elfriede; Hindricks, Gerhard; Mohr, Friedrich–Wilhelm; Borger, Michael A.

doi:10.1016/j.echo.2017.10.004

Cited by 7 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eccentric jet formations due to anomalies of the cusps, cusps restriction and ectasia of the ascending aorta have a relevant influence on VC, PHT and ratio of AR jet width/left ventricular outflow tract (LVOT) width in chronic AR. The analysis of the left subclavian artery flow was more feasible in the present study and has already shown to be an alternative semi-quantitative approach for chronic AR quantification in clinical routine ( 12 ).…”

Section: Discussionmentioning

confidence: 78%

“…In 30 chronic AR patients, the PW Doppler spectrum of the left subclavian artery was documented with a pencil probe to assess the ratio of the diastolic/systolic VTI (VTI dia /VTI sys ) and the ratio of the maximum diastolic/systolic velocity ( V max dia / V max sys ). The diastolic flow reversal in the left subclavian artery has been proposed as a non-inferior approach in comparison to the assessment of the diastolic flow reversal in the descending aorta and as an adjunctive technique for grading of AR severity ( 11 , 12 ).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of chronic aortic regurgitation by 2D and 3D echocardiography and cardiac MRI

et al. 2018

View full text Add to dashboard Cite

PurposeThe study compares the feasibility of the quantitative volumetric and semi-quantitative approach for quantification of chronic aortic regurgitation (AR) using different imaging modalities.MethodsLeft ventricular (LV) volumes, regurgitant volumes (RVol) and regurgitant fractions (RF) were assessed retrospectively by 2D, 3D echocardiography and cMRI in 55 chronic AR patients. Semi-quantitative parameters were assessed by 2D echocardiography.Results22 (40%) patients had mild, 25 (46%) moderate and 8 (14%) severe AR. The quantitative volumetric approach was feasible using 2D, 3D echocardiography and cMRI, whereas the feasibility of semi-quantitative parameters varied considerably. LV volume (LVEDV, LVESV, SVtot) analyses showed good correlations between the different imaging modalities, although significantly increased LV volumes were assessed by cMRI. RVol was significantly different between 2D/3D echocardiography and 2D echocardiography/cMRI but was not significantly different between 3D echocardiography/cMRI. RF was not statistically different between 2D echocardiography/cMRI and 3D echocardiography/cMRI showing poor correlations (r < 0.5) between the different imaging modalities. For AR grading by RF, moderate agreement was observed between 2D/3D echocardiography and 2D echocardiography/cMRI and good agreement was observed between 3D echocardiography/cMRI.ConclusionSemi-quantitative parameters are difficult to determine by 2D echocardiography in clinical routine. The quantitative volumetric RF assessment seems to be feasible and can be discussed as an alternative approach in chronic AR. However, RVol and RF did not correlate well between the different imaging modalities. The best agreement for grading of AR severity by RF was observed between 3D echocardiography and cMRI. LV volumes can be verified by different approaches and different imaging modalities.

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Analysis of chronic aortic regurgitation by 2D and 3D echocardiography and cardiac MRI

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Nevertheless, none of the cases with a non/trace AR had a RF > 14% by LSA-Doppler or > 7% by CMR. For the assessment of RF, an inter-observer coefficient of variation of 12% has been described for the LSA-Doppler [2] and of 6% for CMR imaging [5]. This method inherent variability in association with the presence of a small diastolic regurgitant volume due to coronary perfusion, might explain the overlap in this group of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with vascular shunts of the left upper arm were excluded. As previously described [2], the outer edge of the dense envelope of the spectral recording (i.e. modal velocity) was used to measure the VTI [12].…”

Section: Pulsed Doppler Of the Left Subclavian Artery Velocity Contourmentioning

confidence: 99%

“…The severity of AR can also be evaluated with the estimation of regurgitant fraction (RF) by flow measurement in ascending aorta using cardiovascular magnetic resonance imaging (CMR). Recently, was also validated the assessment of the RF by examination of the left subclavian artery (LSA) velocity contour by pulsed Doppler as an alternative method [1,2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Grading of aortic regurgitation by cardiovascular magnetic resonance and pulsed Doppler of the left subclavian artery: harmonizing grading scales between imaging modalities

Spampinato

Jahnke

Paetsch

et al. 2020

Int J Cardiovasc Imaging

Self Cite

View full text Add to dashboard Cite

Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) are current standard for assessing aortic regurgitation (AR). Regurgitant fraction (RF) can also be estimated by Doppler examination of the left subclavian artery (LSA-Doppler). However, a comparison of AR grading scales using these methods and a TTE multiparametric approach as reference is lacking. We evaluated the severity of AR in 73 patients (58 ± 15 years; 57 men), with a wide spectrum of AR of the native valve. Using a recommended TTE multiparametric approach the AR was divided in none/trace (n = 12), mild (n = 23), moderate (n = 12), and severe (n = 26). RF was evaluated by LSA-Doppler (ratio between diastolic and systolic velocity-time integrals) and by CMR phase-contrast imaging (performed in the aorta 1 cm above the aortic valve); the grading scales were then calculated. There were a good correlation between all methods, but mean RF values were greater with TTE compared with LSA-Doppler and CMR (39 ± 16% vs. 35 ± 18% vs. 32 ± 20%, respectively; p < 0.037). Mean differences in RF values between methods were significant in the groups with mild and moderate AR. Grading scales that best defined the TTE derived AR severity using CMR were: mild, < 21%; moderate, 22 to 41%; and severe, > 42%; and using LSA-Doppler: mild, < 29%; moderate, 30 to 44%; and severe, > 45%. RF values for AR grading using TTE, LSA-Doppler and CMR correlate well but differ in groups with mild and moderate AR when using a recognized multiparametric echocardiographic approach. Clinical prospective studies should validate these proposed modality adjusted grading scales.

show abstract

Technologies for Hemodynamic Measurements: Past, Present and Future

Corazza

Zecchi

Corsini

et al. 2022

Advances in Cardiovascular Technology

View full text Add to dashboard Cite

Quantification of Aortic Valve Regurgitation by Pulsed Doppler Examination of the Left Subclavian Artery Velocity Contour: A Validation Study with Cardiovascular Magnetic Resonance Imaging

Cited by 7 publications

References 17 publications

Analysis of chronic aortic regurgitation by 2D and 3D echocardiography and cardiac MRI

Analysis of chronic aortic regurgitation by 2D and 3D echocardiography and cardiac MRI

Grading of aortic regurgitation by cardiovascular magnetic resonance and pulsed Doppler of the left subclavian artery: harmonizing grading scales between imaging modalities

Technologies for Hemodynamic Measurements: Past, Present and Future

Contact Info

Product

Resources

About