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Quantification of regurgitation in mitral valve prolapse with four-dimensional flow cardiovascular magnetic resonance

التفاصيل البيبلوغرافية
العنوان: Quantification of regurgitation in mitral valve prolapse with four-dimensional flow cardiovascular magnetic resonance
المؤلفون: Franz Sieg, Ingo Paetsch, Gerhard Hindricks, Gerard Crelier, Elfriede Strotdrees, Monika Czaja-Ziolkowska, Frank Lindemann, Florian Fahr, Cosima Jahnke, Michael A. Borger, Ricardo A. Spampinato
المصدر: Journal of Cardiovascular Magnetic Resonance
Journal of Cardiovascular Magnetic Resonance, 23 (1)
Journal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-12 (2021)
سنة النشر: 2020
مصطلحات موضوعية: Male, medicine.medical_specialty, Quantifcation of mitral valve regurgitation, Degenerative mitral regurgitation, Mitral valve prolapse, Fourdimensional, Cardiovascular magnetic resonance, Echocardiography, Magnetic Resonance Spectroscopy, Magnetic Resonance Imaging, Cine, 030204 cardiovascular system & hematology, Severity of Illness Index, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Mitral valve, Internal medicine, medicine, Diseases of the circulatory (Cardiovascular) system, Ventricular outflow tract, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Angiology, Retrospective Studies, Mitral regurgitation, Mitral Valve Prolapse, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Research, Mitral Valve Insufficiency, Reproducibility of Results, Magnetic resonance imaging, Stroke volume, medicine.disease, medicine.anatomical_structure, Four-dimensional, Quantification of mitral valve regurgitation, RC666-701, Regurgitant fraction, Cardiology, cardiovascular system, Cardiology and Cardiovascular Medicine, business
الوصف: Background: Four-dimensional cardiovascular magnetic resonance (CMR) flow assessment (4D flow) allows to derive volumetric quantitative parameters in mitral regurgitation (MR) using retrospective valve tracking. However, prior studies have been conducted in functional MR or in patients with congenital heart disease, thus, data regarding the usefulness of 4D flow CMR in case of a valve pathology like mitral valve prolapse (MVP) are scarce. This study aimed to evaluate the clinical utility of cine-guided valve segmentation of 4D flow CMR in assessment of MR in MVP when compared to standardized routine CMR and transthoracic echocardiography (TTE). Methods: Six healthy subjects and 54 patients (55 ± 16 years; 47 men) with MVP were studied. TTE severity grading used a multiparametric approach resulting in mild/mild-moderate (n = 12), moderate-severe (n = 12), and severe MR (n = 30). Regurgitant volume (RVol) and regurgitant fraction (RF) were also derived using standard volumetric CMR and 4D flow CMR datasets with direct measurement of regurgitant flow (4DFdirect) and indirect calculation using the formula: mitral valve forward flow - left ventricular outflow tract stroke volume (4DFindirect). Results: There was moderate to strong correlation between methods (r = 0.59–0.84, p < 0.001), but TTE proximal isovelocity surface area (PISA) method showed higher RVol as compared with CMR techniques (PISA vs. CMR, mean difference of 15.8 ml [95% CI 9.9–21.6]; PISA vs. 4DFindirect, 17.2 ml [8.4–25.9]; PISA vs. 4DFdirect, 27.9 ml [19.1–36.8]; p < 0.001). Only indirect CMR methods (CMR vs. 4DFindirect) showed moderate to substantial agreement (Lin’s coefficient 0.92–0.97) without significant bias (mean bias 1.05 ± 26 ml [− 50 to 52], p = 0.757). Intra- and inter-observer reliability were good to excellent for all methods (ICC 0.87–0.99), but with numerically lower coefficient of variation for indirect CMR methods (2.5 to 12%). Conclusions: In the assessment of patients with MR and MVP, cine-guided valve segmentation 4D flow CMR is feasible and comparable to standard CMR, but with lower RVol when TTE is used as reference. 4DFindirect quantification has higher intra- and inter-technique agreement than 4DFdirect quantification and might be used as an adjunctive technique for cross-checking MR quantification in MVP.
Journal of Cardiovascular Magnetic Resonance, 23 (1)
ISSN:1097-6647
ISSN:1532-429X
وصف الملف: application/application/pdf
تدمد: 1532-429X
1097-6647
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d184af042fd23791cf69309af741e4a0
https://pubmed.ncbi.nlm.nih.gov/34233708
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....d184af042fd23791cf69309af741e4a0
قاعدة البيانات: OpenAIRE
الوصف
تدمد:1532429X
10976647