What question did this study set out to answer?

The study aims to evaluate the effectiveness of phase contrast CMR in the descending aorta for grading the severity of aortic regurgitation in chronic patients.

January 10, 2026Scientific Reports0 citationsOpen Access

Phase contrast CMR in the descending aorta as a supportive reference for severe aortic regurgitation

FTFrida TruedssonSahlgrenska University Hospital SGSinsia A. GaoSahlgrenska University Hospital CPChristian L. PolteSahlgrenska University Hospital

Key Result

Phase contrast CMR in the descending aorta effectively graded aortic regurgitation severity with 92% sensitivity and 95% specificity, identifying more patients needing intervention.

Key Points

The study aims to evaluate the effectiveness of phase contrast CMR in the descending aorta for grading the severity of aortic regurgitation in chronic patients.
Phase contrast CMR performed in both ascending and descending aorta of 191 patients with chronic aortic regurgitation.
Determination of regurgitation thresholds in the descending aorta for significant aortic regurgitation using Myerson’s outcome-based thresholds.
Validation of findings in a cohort from the clinic.
Comparison of regurgitation measurements with holodiastolic flow reversal.
Strong correlation between regurgitation metrics in descending and ascending aorta (RVol: R ≥ 0.92; RF: R ≥ 0.85; p < 0.001).
High diagnostic performance for RVol DA > 17 mL (sensitivity: 92%, specificity: 95%).
High diagnostic performance for RF DA > 23% (sensitivity: 83%, specificity: 93%).
More patients identified with significant aortic regurgitation using PC-MRI thresholds compared to holodiastolic flow reversal alone.

Structured PICO

Does phase contrast CMR in the descending aorta accurately identify hemodynamically significant aortic regurgitation in patients with chronic AR?

Population

191 patients with chronic aortic regurgitation (AR). Cohort 1 (n=43, 24-80 years, 16% female) had indication for intervention with severe chronic AR or follow-up with moderate chronic AR. Cohort 2 (n=148, 20-80 years, 32% female) had known or suspected AR from clinical practice. Exclusions: aortic prosthetic valve, moderate regurgitation in any other valve, intracardiac shunt, any other form of cardiac disease, and irregular heart rhythm.

Intervention

Phase contrast cardiovascular magnetic resonance (PC-CMR) measurements in the descending aorta to determine regurgitation volume (RVolDA) and regurgitation fraction (RFDA).

Comparator

Standard PC-CMR measurements in the ascending aorta using Myerson's outcome-based thresholds (RVol > 42 mL, RF > 33%) and holodiastolic flow reversal (HFR).

Outcome

Diagnostic performance (sensitivity, specificity, positive/negative likelihood ratios) of descending aorta PC-CMR thresholds for identifying hemodynamically significant aortic regurgitation.surrogate

Phase contrast CMR in the descending aorta provides highly accurate, supportive thresholds (RVol >17 mL, RF >23%) for grading aortic regurgitation severity, which is especially useful when standard ascending aorta measurements are limited.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Accurate grading of aortic regurgitation (AR) severity is crucial for treatment decisions. This study aimed to determine whether phase contrast cardiac magnetic resonance (PC-CMR) in the descending aorta can be used as a supporting reference for grading of the AR severity in patients with chronic AR. PC-CMR was performed both in the ascending and descending aorta of 191 AR-patients. Regurgitation thresholds in the descending aorta for hemodynamically significant AR regurgitation volume (RVol) DA and fraction (RF) DA were determined in 41 well-controlled patients and then validated in a cohort surveyed for AR in our clinic. Myerson’s outcome-based thresholds (RVol > 42 mL, RF > 33%) served as reference. For comparison, holodiastolic flow reversal (HFR) was determined. Regurgitation measurements in the descending and ascending aorta were strongly correlated (RVol: R ≥ 0.92; RF: R ≥ 0.85; p 17 mL and RF DA >23% was high (sensitivity: 92%, 83%; specificity: 95%, 93%) and more patients with significant AR were identified using these PC-MRI based thresholds RVol DA >17mL (13%) and RF DA >23% (15%) than with HFR alone. PC-CMR in the descending aorta has the potential to reliably grade AR severity in patients with chronic AR and thereby may serve as a supportive reference in the decision-making regarding optimal timing of intervention.

Ask AI

Helpful

Bookmark

View Full Paper