Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling

Transthoracic echocardiography (TTE) is the primary clinical imaging modality for the assessment of patients with isolated aortic regurgitation (AR) in whom TTE’s linear left ventricular (LV) dimension is used to assess disease severity to guide aortic valve replacement (AVR), yet TTE is relatively...

Full description

Bibliographic Details
Main Authors: Neisius, Ulf, Tsao, Connie W., Hauser, Thomas H., Patel, Apranta D., Pierce, Patrick, Ben Assa, Eyal Benjamin, Nezafat, Reza, Manning, Warren J.
Other Authors: Massachusetts Institute of Technology. Institute for Medical Engineering & Science
Format: Article
Language:English
Published: Springer Science and Business Media LLC 2020
Online Access:https://hdl.handle.net/1721.1/128533
_version_ 1811094870379462656
author Neisius, Ulf
Tsao, Connie W.
Hauser, Thomas H.
Patel, Apranta D.
Pierce, Patrick
Ben Assa, Eyal Benjamin
Nezafat, Reza
Manning, Warren J.
author2 Massachusetts Institute of Technology. Institute for Medical Engineering & Science
author_facet Massachusetts Institute of Technology. Institute for Medical Engineering & Science
Neisius, Ulf
Tsao, Connie W.
Hauser, Thomas H.
Patel, Apranta D.
Pierce, Patrick
Ben Assa, Eyal Benjamin
Nezafat, Reza
Manning, Warren J.
author_sort Neisius, Ulf
collection MIT
description Transthoracic echocardiography (TTE) is the primary clinical imaging modality for the assessment of patients with isolated aortic regurgitation (AR) in whom TTE’s linear left ventricular (LV) dimension is used to assess disease severity to guide aortic valve replacement (AVR), yet TTE is relatively limited with regards to its integrated semi-quantitative/qualitative approach. We therefore compared TTE and cardiovascular magnetic resonance (CMR) assessment of isolated AR and investigated each modality’s ability to predict LV remodeling after AVR. AR severity grading by CMR and TTE were compared in 101 consecutive patients referred for CMR assessment of chronic AR. LV end-diastolic diameter and end-systolic diameter measurements by both modalities were compared. Twenty-four patients subsequently had isolated AVR. The pre-AVR estimates of regurgitation severity by CMR and TTE were correlated with favorable post-AVR LV remodeling. AR severity grade agreement between CMR and TTE was moderate (ρ = 0.317, P = 0.001). TTE underestimated CMR LV end-diastolic and LV end-systolic diameter by 6.6 mm (P < 0.001, CI 5.8–7.7) and 5.9 mm (P < 0.001, CI 4.1–7.6), respectively. The correlation of post-AVR LV remodeling with CMR AR grade (ρ = 0.578, P = 0.004) and AR volumes (R = 0.664, P < 0.001) was stronger in comparison to TTE (ρ = 0.511, P = 0.011; R = 0.318, P = 0.2). In chronic AR, CMR provides more prognostic relevant information than TTE in assessing AR severity. CMR should be considered in the management of chronic AR patients being considered for AVR.
first_indexed 2024-09-23T16:06:49Z
format Article
id mit-1721.1/128533
institution Massachusetts Institute of Technology
language English
last_indexed 2024-09-23T16:06:49Z
publishDate 2020
publisher Springer Science and Business Media LLC
record_format dspace
spelling mit-1721.1/1285332022-10-02T06:26:51Z Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling Neisius, Ulf Tsao, Connie W. Hauser, Thomas H. Patel, Apranta D. Pierce, Patrick Ben Assa, Eyal Benjamin Nezafat, Reza Manning, Warren J. Massachusetts Institute of Technology. Institute for Medical Engineering & Science Transthoracic echocardiography (TTE) is the primary clinical imaging modality for the assessment of patients with isolated aortic regurgitation (AR) in whom TTE’s linear left ventricular (LV) dimension is used to assess disease severity to guide aortic valve replacement (AVR), yet TTE is relatively limited with regards to its integrated semi-quantitative/qualitative approach. We therefore compared TTE and cardiovascular magnetic resonance (CMR) assessment of isolated AR and investigated each modality’s ability to predict LV remodeling after AVR. AR severity grading by CMR and TTE were compared in 101 consecutive patients referred for CMR assessment of chronic AR. LV end-diastolic diameter and end-systolic diameter measurements by both modalities were compared. Twenty-four patients subsequently had isolated AVR. The pre-AVR estimates of regurgitation severity by CMR and TTE were correlated with favorable post-AVR LV remodeling. AR severity grade agreement between CMR and TTE was moderate (ρ = 0.317, P = 0.001). TTE underestimated CMR LV end-diastolic and LV end-systolic diameter by 6.6 mm (P < 0.001, CI 5.8–7.7) and 5.9 mm (P < 0.001, CI 4.1–7.6), respectively. The correlation of post-AVR LV remodeling with CMR AR grade (ρ = 0.578, P = 0.004) and AR volumes (R = 0.664, P < 0.001) was stronger in comparison to TTE (ρ = 0.511, P = 0.011; R = 0.318, P = 0.2). In chronic AR, CMR provides more prognostic relevant information than TTE in assessing AR severity. CMR should be considered in the management of chronic AR patients being considered for AVR. 2020-11-18T23:04:41Z 2020-11-18T23:04:41Z 2019-08 2019-02 2020-09-24T20:38:31Z Article http://purl.org/eprint/type/JournalArticle 1569-5794 1573-0743 https://hdl.handle.net/1721.1/128533 Neisius, Ulf et al. "Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling." International Journal of Cardiovascular Imaging 36, 1 (August 2019): 91–100. © 2019 Springer Nature B.V. en https://doi.org/10.1007/s10554-019-01682-x International Journal of Cardiovascular Imaging Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use. Springer Nature B.V. application/pdf Springer Science and Business Media LLC Springer Netherlands
spellingShingle Neisius, Ulf
Tsao, Connie W.
Hauser, Thomas H.
Patel, Apranta D.
Pierce, Patrick
Ben Assa, Eyal Benjamin
Nezafat, Reza
Manning, Warren J.
Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling
title Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling
title_full Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling
title_fullStr Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling
title_full_unstemmed Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling
title_short Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling
title_sort aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography intermodality disagreement impacting on prediction of post surgical left ventricular remodeling
url https://hdl.handle.net/1721.1/128533
work_keys_str_mv AT neisiusulf aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling
AT tsaoconniew aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling
AT hauserthomash aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling
AT patelaprantad aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling
AT piercepatrick aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling
AT benassaeyalbenjamin aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling
AT nezafatreza aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling
AT manningwarrenj aorticregurgitationassessmentbycardiovascularmagneticresonanceimagingandtransthoracicechocardiographyintermodalitydisagreementimpactingonpredictionofpostsurgicalleftventricularremodeling