0488: Assessment of aortic regurgitation severity: a cardiac magnetic resonance and echocardiographic comparison study - 12/02/16
Résumé |
Background |
Assessment of chronic aortic regurgitation (AR) severity remains challenging. While transthoracic echocardiography (TTE) is the most widely used method, velocity-encoded phase-contrast magnetic resonance (PCMR) imaging in the ascending aorta for flow quantification is considered the gold standard method to calculate the regurgitant volume (Reg Vol). The aim of our study was to compare the AR severity by TTE and PCMR in a large serie of consecutive patients with aortic valvular heart disease (VHD).
Methods and results |
between 2007 and 2014, 283 patients underwent clinically indicated TTE and PCMR (Philips ACHIEVA 1.5 Tesla) within 30 days. Multiparametric approach was used by TTE (vena contracta, pisa method and semi-quantitative method) to grade AR severity. Mean age was 81±9 years, 53% were male. LVEF was not significantly different between TTE and CMR (55±13% and 53±15%); mean trans aortic gradient was>40mmHg in 53% patients. AR was respectively graded 0, 1, 2, 3 and 4 in 51%, 19%, 13%; 8% and 8% by TTE which corresponded to a Reg Vol of 5.3±3.9mL, 16±3, 26±4, 37±5, and 57±9mL respectively as obtained by PCMR. There was no significant overlap between different Reg vol by PCMR and the 5 grade obtained by TTE; The relation between AR- Reg vol and grade by TTE was not significantly affected by the mean trans-aortic gradient (i.e>or<40mmHg).
Conclusion |
TTE as used in routine practice, allows a good discrimination and quantification of chronic AR when compared to that performed by CMR. However, PCMR can be an excellent alternative to TTE in patients who undergo TAVR in whom AR assessment by TTE is often challenging.
Le texte complet de cet article est disponible en PDF.Vol 8 - N° 1
P. 54 - janvier 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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