[en] BACKGROUND: Two-dimensional transthoracic echocardiography (2DTTE) remains the first-line diagnostic imaging tool to assess primary mitral regurgitation although cardiovascular magnetic resonance (CMR) has proven to establish left ventricular function more accurately and might evaluate mitral regurgitation severity more reliably. We sought to compare routine evaluation of left ventricular function and mitral regurgitation severity by 2DTTE with assessment by CMR in moderate to severe primary mitral regurgitation without overt left ventricular dysfunction. METHODS: We prospectively included 38 patients (79% of male, age 57 +/- 14 years) with at least moderate primary mitral regurgitation, a left ventricular ejection fraction >/=60% and a left ventricular end-systolic diameter </=45 mm. Patients with evidence of coronary artery disease, arrhythmias or significant concomitant valvular disease were excluded. All patients were scheduled for 2DTTE and CMR. RESULTS: Left ventricular end-diastolic and end-systolic volumes were significantly underestimated by 2DTTE in comparison with CMR, although there was a strong correlation (Pearson r = 0.81, p < 0.00001 and r = 0.7, p < 0.00001, respectively). Measurement of the regurgitant orifice was similar between 2DTTE PISA method and planimetry by CMR (47 +/- 24 vs. 42 +/- 16 mm2, p = 0.12) with a strong correlation between both imaging techniques (Pearson r = 0.76, p < 0.0001). By contrast, assessment of the regurgitant volume by 2DTTE and by phase contrast velocity mapping by CMR showed poor agreement. CONCLUSIONS: In moderate to severe primary mitral regurgitation without overt left ventricular dysfunction, 2DTTE significantly underestimates left ventricular remodelling in comparison to CMR. Measurement of the regurgitant orifice with planimetry by CMR shows good agreement with the PISA method by 2DTTE and thus may be a valuable alternative to assess mitral regurgitation severity.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Van De Heyning, Caroline M.
Magne, Julien ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Pierard, Luc ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
BRUYERE, Pierre-Julien ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiodiagnostic
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
The role of multi-imaging modality in primary mitral regurgitation. Van de Heyning CM, Magne J, Vrints CJ, Piérard L, Lancellotti P, Eur Heart J Cardiovasc Imaging 2012 13 139 151 10.1093/ejechocard/jer257 22127625
Triggers for surgical referral in degenerative mitral valve regurgitation. Itagaki S, Adams DH, Anyanwu AC, Circ J 2012 77 28 34 23123553
Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Lancellotti P, Tribouilloy C, Hagendorff A, Popescu BA, Edvardsen T, Pierard LA, Badano L, Zamorano JL, Eur Heart J Cardiovasc Imaging 2013 14 611 644 10.1093/ehjci/jet105 23733442
Guidelines on the management of valvular heart disease (version 2012): The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, Borger MA, Carrel TP, De Bonis M, Evangelista A, Falk V, Iung B, Lancellotti P, Pierard L, Price S, Schäfers HJ, Schuler G, Stepinska J, Swedberg K, Takkenberg J, Von Oppell UO, Windecker S, Zamorano JL, Zembala M, Eur Heart J 2012 2012 33 2451 2496
Assessment of left ventricular volumes by magnetic resonance in comparison with radionuclide angiography, contrast angiography and echocardiography. Mogelvang J, Stokholm KH, Saunamaki K, Reimer A, Stubgaard M, Thomsen C, Fritz-Hansen P, Henriksen O, Eur Heart J 1992 13 1677 1683 1289099 (Pubitemid 23070861)
Quantification of mitral regurgitation by velocity-encoded cine nuclear magnetic resonance imaging. Fujita N, Chazouilleres AF, Hartiala JJ, O'Sullivan M, Heidenreich P, Kaplan JD, Sakuma H, Foster E, Caputo GR, Higgins CB, J Am Coll Cardiol 1994 23 951 958 10.1016/0735-1097(94)90642-4 8106701 (Pubitemid 24090882)
Cardiovascular magnetic resonance for direct assessment of anatomic regurgitant orifice in mitral regurgitation. Buchner S, Debl K, Poschenrieder F, Feuerbach S, Riegger GA, Luchner A, Djavidani B, Circ Cardiovasc Imaging 2008 1 148 155 10.1161/CIRCIMAGING.107.753103 19808532
Recommendations for chamber quantification. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W, Eur J Echocardiogr 2006 7 79 108 10.1016/j.euje.2005.12.014 16458610 (Pubitemid 43257193)
MRI of left ventricular function. Epstein FH, J Nucl Cardiol 2007 14 729 744 10.1016/j.nuclcard.2007.07.006 17826327 (Pubitemid 47355088)
Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance; are they interchangeable? Bellenger NG, Burgess MI, Ray SG, Lahiri A, Coats AJ, Cleland JG, Pennell DJ, Eur Heart J 2000 21 1387 1396 10.1053/euhj.2000.2011 10952828 (Pubitemid 30599134)
Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography. Hoffmann R, von Bardeleben S, ten Cate F, Borges AC, Kasprzak J, Firschke C, Lafitte S, Al-saadi N, Kuntz-Hehner S, Engelhardt M, Becher H, Vanoverschelde JL, Eur Heart J 2005 26 607 616 15618026 (Pubitemid 40461103)
2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS, J Am Coll Cardiol 2008 52 1 e142 10.1016/j.jacc.2008.05.007 18848134
Magnetic resonance imaging with 3-dimensional analysis of left ventricular remodeling in isolated mitral regurgitation: implications beyond dimensions. Schiros CG, Dell'Italia LJ, Gladden JD, Clark D, Aban I, Gupta H, Lloyd SG, McGiffin DC, Perry G, Denney TS, Ahmed MI, Circulation 2012 125 2334 2342 10.1161/CIRCULATIONAHA.111.073239 22496130
Assessment of cardiac remodeling in asymptomatic mitral regurgitation for surgery timing: a comparative study of echocardiography and magnetic resonance imaging. Ozdogan O, Yuksel A, Gurgun C, Kayikcioglu M, Yavuzgil O, Cinar CS, Cardiovasc Ultrasound 2010 8 32 10.1186/1476-7120-8-32 20704764
Broad-beam spectral Doppler sonification of the vena contracta using matrix-array technology: a new solution for semi-automated quantification of mitral regurgitant flow volume and orifice area. Buck T, Plicht B, Hunold P, Mucci RA, Erbel R, Levine RA, J Am Coll Cardiol 2005 45 770 779 10.1016/j.jacc.2004.11.036 15734624 (Pubitemid 40278977)
Comparison of accuracy of mitral valve regurgitation volume determined by three-dimensional transesophageal echocardiography versus cardiac magnetic resonance imaging. Hamada S, Altiok E, Frick M, Almalla M, Becker M, Marx N, Hoffmann R, Am J Cardiol 2012 110 1015 1020 10.1016/j.amjcard.2012.05.037 22727180
Direct quantification of mitral regurgitant flow volume by real-time three-dimensional echocardiography using dealiasing of color Doppler flow at the vena contracta. Plicht B, Kahlert P, Goldwasser R, Janosi RA, Hunold P, Erbel R, Buck T, J Am Soc Echocardiogr 2008 21 1337 1346 10.1016/j.echo.2008.09.022 19041578
Quantitative assessment of mitral regurgitation: comparison between three-dimensional transesophageal echocardiography and magnetic resonance imaging. Shanks M, Siebelink HM, Delgado V, van de Veire NR, Ng AC, Sieders A, Schuijf JD, Lamb HJ, Ajmone Marsan N, Westenberg JJ, Kroft LJ, de Roos A, Bax JJ, Circ Cardiovasc Imaging 2010 3 694 700 10.1161/CIRCIMAGING.110.947176 20810848
Three-dimensional echocardiography: the benefits of the additional dimension. Lang RM, Mor-Avi V, Sugeng L, Nieman PS, Sahn DJ, J Am Coll Cardiol 2006 48 2053 2069 10.1016/j.jacc.2006.07.047 17112995 (Pubitemid 44738445)
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.
