Value of qualitative angiographic grading in aortic regurgitation

Abstract

The aim of this study was to assess the accuracy of angiographic grading of regurgitation in patients with aortic regurgitation (AR). In 204 adult patients (149 men, 55 women, aged 51 +/- 13 years) with AR, the forward cardiac index was measured by the indicator dilution technique, and the left ventricular angiographic index by the area length method, from which the regurgitant stroke index and the percentage of regurgitation were calculated. In 80 other patients without regurgitation, there was a good correlation between forward and angiographic cardiac indices (r = 0.83, P less than 0.001). Aortic regurgitation graded on a 1-4 scale was, in the 204 patients with AR, correlated with the percentage and the volume of regurgitation (respectively r = 0.87, P less than 0.001 and r = 0.92, P less than 0.001). The regurgitant stroke index and the percentage of regurgitation were significantly different from one group to another (P less than 0.001). However, there was a range in amount of regurgitation within each grade and an overlap from one grade to another. There were no differences in regurgitant stroke index or in the percentage of regurgitation when patients were categorized according to LV end-diastolic or endsystolic volume, LV ejection fraction, forward cardiac index or intracardiac pressure.

Guidelines for the Evaluation of Valvular Regurgitation After Percutaneous Valve Repair or Replacement

“…Angiographic grading, while helpful in extremes, may not correlate well with quantitative assessment of AR severity, and cannot reliably distinguish central from paravalvular regurgitation. 20,50,51 2. Hemodynamic Assessment in the Catheterization Laboratory.…”

A Novel Angiographic Quantification of Aortic Regurgitation After TAVR Provides an Accurate Estimation of Regurgitation Fraction Derived From Cardiac Magnetic Resonance Imaging

“…Aortic root angiography is the first screening tool for PVR in most laboratories and is a quick and friendly tool to the interventionists. However, the visual (Sellers') assessment is subjective, qualitative, and nonvalidated in the post-TAVR setting (4).I t has been previously reported that native aortic valve regurgitation volume and fraction measured by magnetic flowmetry (26) and by cardiac catheterization (using Fick's method and left ventriculography) (27)(28)(29)…”

Results of balloon and surgical valvuloplasty in congenital aortic valve stenosis: A 19-year, single-center, retrospective study

“…Trivial aortic stenosis was defined as a transvalvular Doppler peak-systolic gradient less than 25 mmHg, mild stenosis as 25 to 49 mmHg, moderate stenosis as 50 to 75 mmHg, and severe stenosis as greater than 75 mmHg. [ 11 , 12 ] Both angiographic[ 13 , 14 ] and echocardiographic[ 11 ] examinations were used to classify the aortic regurgitation associated with the procedure. Aortic valve morphology was classified by echocardiography as monocuspid, bicuspid (functional or anatomic bicuspid), and tricuspid.…”