Qualitative Echocardiographic Assessment of Aortic Valve Regurgitation with Quantitative Cardiac Magnetic Resonance: A Comparative Study

Kutty, Shelby; Whitehead, Kevin K.; Natarajan, Shobha; Harris, Matthew A.; Wernovsky, Gil; Fogel, Mark A.
October 2009
Pediatric Cardiology;Oct2009, Vol. 30 Issue 7, p971
Academic Journal
This study examined the correlation of echocardiography (ECHO) and Cardiac Magnetic Resonance (CMR) in the assessment of aortic valve regurgitation (AR) in children and young adults with congenital heart disease. We hypothesized that qualitative ECHO assessment correlates insufficiently with quantitative CMR data and compared subjective ECHO evaluations with objective measurement of regurgitant fractions (RF) by CMR. Patients who had both ECHO and CMR assessments of AR within 60 days of each other were included. The qualitative ECHO assessment (mild, moderate, severe) of AR and left ventricular dimension at end diastole were recorded. RF was quantified by CMR using phase-contrast velocity mapping. Repeat ECHO review and grading of AR was performed by a blinded single reader in a randomly chosen subgroup of patients. In 43 patients studied, statistical significance was observed in the CMR-RF between mild and moderate, and between mild and severe ECHO grades. There was significant overlap of objective RF between subjective grades. Mild ECHO AR corresponded to an RF (%) of 0–29, moderate 1–40, and severe 5–58. Overlap was more significant at moderate and severe grades. Results were similar in the group in whom a single reader interpreted the ECHO assessment. In conclusion, results derived from a real-life multiple-reader ECHO laboratory showed inconsistencies in ECHO grading of AR, with a wide range of objectively measured RF within a given ECHO grade. ECHO is less reliable in identifying more severe AR, often overestimating severity. Quantitative CMR is a potentially useful supplement to ECHO for management decisions and assessments of medical and surgical therapies in children and young adults with AR.


Related Articles

  • Qualitative grading of aortic regurgitation: a pilot study comparing CMR 4D flow and echocardiography. Chelu, Raluca; van den Bosch, Annemien; Kranenburg, Matthijs; Hsiao, Albert; van den Hoven, Allard; Ouhlous, Mohamed; Budde, Ricardo; Beniest, Kirsten; Swart, Laurens; Coenen, Adriaan; Lubbers, Marisa; Wielopolski, Piotr; Vasanawala, Shreyas; Roos-Hesselink, Jolien; Nieman, Koen; Chelu, Raluca G; van den Bosch, Annemien E; van Kranenburg, Matthijs; van den Hoven, Allard T; Budde, Ricardo P J // International Journal of Cardiovascular Imaging;Feb2016, Vol. 32 Issue 2, p301 

    Over the past 10 years there has been intense research in the development of volumetric visualization of intracardiac flow by cardiac magnetic resonance (CMR).This volumetric time resolved technique called CMR 4D flow imaging has several advantages over standard CMR. It offers anatomical,...

  • Echocardiographic Evidence of Cardiac Involvement in Ankylosing Spondylitis. Yildirir, A.; Aksoyek, S.; Calguneri, M.; Oto, A.; Kes, S. // Clinical Rheumatology;May2002, Vol. 21 Issue 2, p129 

    : Aortic insufficiency, myocardial fibrosis and conduction disturbances are known complications of ankylosing spondylitis (AS). However, few studies have assessed left ventricular diastolic function and no data are available about P-wave analysis. In this study 88 AS patients and 31 healthy...

  • B-type natriuretic peptide and left ventricular dysfunction on exercise echocardiography in patients with chronic aortic regurgitation. Gabriel, R. S.; Kerr, A .J.; Sharma, V.; Zeng, I. S. L.; Stewart, A. A. H. // Heart;Jul2008, Vol. 94 Issue 7, p897 

    Objective: To determine whether plasma levels of B-type natriuretic peptide (BNP) predict left ventricular (LV) dysfunction on exercise echocardiography in patients with moderate to severe aortic regurgitation (AR). Design: Case-control study. Setting: Outpatient cardiology departments....

  • Evaluating paravalvular leak after TAVR. Gopalakrishnan, Deepika; Gopal, Ambarish; Grayburn, Paul A. // Heart;Dec2014, Vol. 100 Issue 24, p1903 

    The article presents a study on aortic valve insufficiency post transcatheter aortic valve replacement (TAVR) emphasizing on its most significant cause paravalvular leak (PVL). It states that the paravalvular leak majorly takes place due to undersize of the valve. Studies on transthoracic...

  • Temporal changes in left ventricular function and paravalvular aortic regurgitation after transcatheter aortic valve implantation: a cardiac magnetic resonance imaging study. Merten, Constanze; Beurich, Hans-Wilko; Zachow, Dirk; Mostafa, Ahmad E.; Gordian, Ken; Toelg, Ralph; Geist, Volker; Abdel-Wahab, Mohamed; Richardt, Gert H. // Journal of Cardiovascular Magnetic Resonance (BioMed Central);2012 Supplement, Vol. 14 Issue Suppl 1, p1 

    An abstract of the conference paper "Temporal changes in left ventricular function and paravalvular aortic regurgitation after transcatheter aortic valve implantation: a cardiac magnetic resonance imaging study," by Ken Gordian, and colleagues is presented.

  • Quantification of aortic regurgitation using high-pulse repetition frequency three-dimensional colour Doppler. Skaug, Thomas R.; Amundsen, Brage H.; Hergum, Torbjørn; Urheim, Stig; Torp, Hans; Haugen, Bjørn Olav // European Heart Journal - Cardiovascular Imaging;Jun2014, Vol. 15 Issue 6, p615 

    Aims The aim of this study was to validate and assess the feasibility of a previously described method using multibeam high-pulse repetition frequency (HPRF) colour Doppler to quantify the vena contracta area (VCA) in aortic regurgitation (AR). Methods Twenty-nine patients with mild to severe AR...

  • Evaluation of aortic regurgitation in congenital heart disease: value of MR imaging in comparison to echocardiography. Ley, Sebastian; Eichhorn, Joachim; Ley-Zaporozhan, Julia; Ulmer, Herbert; Schenk, Jens-Peter; Kauczor, Hans-Ulrich; Arnold, Raoul // Pediatric Radiology;May2007, Vol. 37 Issue 5, p426 

    Background: Evaluation of the severity and the follow-up of aortic insufficiency (AI) are important tasks in paediatric cardiology. Assessment is based on clinical and echocardiographic (ECHO) findings such as the configuration of the valve and the regurgitation fraction...

  • Cardiovascular magnetic resonance imaging for bicuspid aortic valve syndrome: the time is now. Shenoy, Chetan; Maron, Martin S.; Pandian, Natesa G. // European Heart Journal - Cardiovascular Imaging;Jun2014, Vol. 15 Issue 6, p612 

    The authors reflect on a study by R. Wassmuth and colleagues on cardiovascular magnetic resonance imaging for bicuspid aortic valve syndrome, published within the issue. Topics discussed include the components of congenital abiscupid aortic valve, such as aortic valve stenosis, ascending aortic...

  • Cardiovascular Magnetic Resonance Imaging for Intensive Care Infants: Safe and Effective? Sarikouch, Samir; Schaeffler, Rainer; Körperich, Hermann; Dongas, Aristidis; Haas, Nikolaus; Beerbaum, Philipp // Pediatric Cardiology;Feb2009, Vol. 30 Issue 2, p146 

    Background Cardiac magnetic resonance imaging (MRI) is an important diagnostic tool for congenital heart disease (CHD), as reflected by class 1 recommendations for the use of cardiac MRI by various consensus panels. However, little is known about the safety and clinical utility of cardiac MRI...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics