Assessment of Asymptomatic Severe Aortic Regurgitation by Doppler-Derived Echo Indices: Comparison with Magnetic Resonance Quantification.
Zuzana HlubockáRadka KockovaHana LínkováAlena PravečkováJaroslav HlubockýGabriela DostalovaMartin BláhaMartin PěničkaAleš LinhartPublished in: Journal of clinical medicine (2021)
Reliable quantification of aortic regurgitation (AR) severity is essential for clinical management. We aimed to compare quantitative and indirect echo-Doppler indices to quantitative cardiac magnetic resonance (CMR) parameters in asymptomatic chronic severe AR. Methods and Results: We evaluated 104 consecutive patients using echocardiography and CMR. A comprehensive 2D, 3D, and Doppler echocardiography was performed. The CMR was used to quantify regurgitation fraction (RF) and volume (RV) using the phase-contrast velocity mapping technique. Concordant grading of AR severity with both techniques was observed in 77 (74%) patients. Correlation between RV and RF as assessed by echocardiography and CMR was relatively good (r s = 0.50 for RV, r s = 0.40 for RF, p < 0.0001). The best correlation between indirect echo-Doppler and CMR parameters was found for diastolic flow reversal (DFR) velocity in descending aorta (r s = 0.62 for RV, r s = 0.50 for RF, p < 0.0001) and 3D vena contracta area (VCA) (r s = 0.48 for RV, r s = 0.38 for RF, p < 0.0001). Using receiver operating characteristic analysis, the largest area under curve (AUC) to predict severe AR by CMR RV was observed for DFR velocity (AUC = 0.79). DFR velocity of 19.5 cm/s provided 78% sensitivity and 80% specificity. The AUC for 3D VCA to predict severe AR by CMR RV was 0.73, with optimal cut-off of 26 mm 2 (sensitivity 80% and specificity 66%). Conclusions: Out of the indirect echo-Doppler indices of AR severity, DFR velocity in descending aorta and 3D vena contracta area showed the best correlation with CMR-derived RV and RF in patients with chronic severe AR.
Keyphrases
- mycobacterium tuberculosis
- magnetic resonance
- blood flow
- aortic valve
- left ventricular
- end stage renal disease
- ejection fraction
- contrast enhanced
- early onset
- aortic stenosis
- newly diagnosed
- computed tomography
- pulmonary artery
- chronic kidney disease
- pulmonary hypertension
- high resolution
- diffusion weighted
- transcatheter aortic valve replacement
- drug induced
- peritoneal dialysis
- prognostic factors
- magnetic resonance imaging
- blood pressure
- heart failure
- patient reported outcomes
- atrial fibrillation
- pulmonary arterial hypertension