Flow convergence parameters from the parasternal long axis window correlated well with CMR-derived regurgitant volume and identified significant aortic regurgitation in 83% of patients.
Does two-dimensional measurement of flow convergence from the parasternal long-axis window accurately assess aortic regurgitation severity compared to cardiac magnetic resonance in patients with chronic aortic regurgitation?
Flow convergence from the parasternal long-axis window is a highly feasible and accurate nonvolumetric echocardiographic method for assessing chronic aortic regurgitation severity, performing comparably to CMR and traditional Doppler parameters.
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Abstract Aim To assess whether two-dimensional measurements of flow convergence (FC) from the standard parasternal long-axis (PLA) window relate to aortic regurgitation (AR) severity. Methods and Results Patients with chronic AR who underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) within 4 hours were included. FCPLA was assessed using 3 parameters: the maximum length (Lmax), width (Dmax), and hemispheric area. Traditional echo/Doppler parameters of AR severity were measured per guidelines. FC and other echo/Doppler results were compared to CMR-derived regurgitant volume (RegV). A total of 80 patients were evaluated. AR was significant by CMR (RegV 45 ml) in 41% of patients. FCPLA parameters were measurable in 83% of patients whereas apical PISA quantitation was feasible in only 39%. FCPLA measurements correlated well with CMR RegV: Spearman ρ = 0.75 for Lmax, ρ = 0.65 for Dmax, and ρ = 0.78 for area. The AUC values of Lmax = 0.55cm, Dmax = 0.65cm, and FCPLA area = 0.35 cm2 for identifying significant AR were 0.98, 0.84, and 0.94, respectively, with Lmax and FC area demonstrating significantly higher AUCs. They were comparable to those of vena contracta width (AUC = 0.94) and left ventricular end-diastolic volume index (AUC= 0.91) and superior to those of jet width/LVOT diameter (AUC = 0.80), descending aorta end-diastolic velocity (AUC = 0.74), and pressure half-time (AUC= 0.71). Conclusion In chronic AR, flow convergence is more identifiable from the parasternal long axis window compared to traditional PISA measured from the apical window. FCPLA nonvolumetric parameters relate well to AR severity by CMR and are comparable to conventional echo/Doppler parameters.
Zeitoun et al. (Sun,) reported a other. Flow convergence parameters from the parasternal long axis window correlated well with CMR-derived regurgitant volume and identified significant aortic regurgitation in 83% of patients.